[Discontinuation or tapering strategies of biologics in rheumatoid arthritis in remission].

[Discontinuation or tapering strategies of biologics in rheumatoid arthritis in remission].
Rev Med Interne. 2017 Feb 01;:
Authors: Mallick A, Fautrel B, Sagez F, Sordet C, Javier RM, Petit H, Chatelus E, Rahal N, Gottenberg JE, Sibilia J
Abstract
The arrival of new drugs and new therapeutic strategies allowed to reach sustained remission in an increasing number of patients with rheumatoid arthritis. The study of biologic disease-modifying anti-rheumatic drugs (bDMARDs) adaptation strategies is a need to optimize the benefit/risk balance and cost/effectiveness ratio of these molecules. Current recommendations such as EULAR 2016 propose tapering bDMARDs, especially when combined with a csDMARD, when the patient is in remission after stopping persistent glucocorticoids. The analysis of literature comprising 22 studies shows that a bDMARD adaptation is possible in established rheumatoid arthritis when clinico-biological and ultrasound remission is maintained over six months. Priority should be given to a progressive tapering strategy doses controlled by disease activity while maintaining "tight control" to identify and effectively treat a relapse, a retreatment being usually favorable.
PMID: 28161110 [PubMed - as supplied by publisher]

Source: Revue de Medecine Interne - February 7, 2017 Category: Internal Medicine Tags: Rev Med Interne Source Type: research