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Ankylosing Spondylitis — SCE Rheumatology MCQ

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ModerateSpondyloarthropathyAnkylosing SpondylitisSCE Rheumatology

A 38-year-old man with axial spondyloarthropathy achieves sustained low disease activity (ASDAS <2.1) on Adalimumab for 12 months. According to BSR 2025 guidelines, what approach to treatment modification should be considered?

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Correct answer: A — Taper by extending the dosing interval

BSR 2025 axSpA guidelines recommend that tapering of targeted therapy can be considered in patients who have achieved sustained inactive disease or low disease activity. The recommended approach is to extend the dosing interval gradually rather than abruptly stopping. Most patients who completely withdraw targeted therapy will relapse, though re-treatment is usually effective. Switching drug class or to csDMARDs is not the recommended tapering strategy.

Reference: BSR 2025 - Guideline for treatment of axSpA with biologic and targeted synthetic DMARDs