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Gradual TNFi vs csDMARD Tapering in Rheumatoid Arthritis

Researchers evaluated the effectiveness of 2 tapering strategies in patients with RA who had achieved controlled disease activity.

In patients with rheumatoid arthritis (RA), flare rates associated with the tapering of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) or tumor necrosis factor inhibitors (TNFis) are similar up to 9 months, according to the results published in Annals of the Rheumatic Diseases. After 1 year, however, a nonsignificant difference of 10% that favored csDMARD tapering was reported.

The multicenter, single-blinded randomized TARA trial was conducted in 12 rheumatology centers in the Southwestern part of The Netherlands. The investigators sought to compare the effectiveness of 2 tapering strategies — gradually tapering csDMARDs or gradually tapering TNFis — in patients with RA who had controlled disease with a combination of csDMARDs and a TNFi. Controlled disease was defined as a Disease Activity Score (DAS) of ≤2.4 and a swollen joint count of ≤1 in patients receiving treatment with a csDMARD plus a TNFi. Eligible patients were randomly assigned into 1 of 2 groups: gradual tapering of csDMARDs or gradual tapering of TNFis. Patient medication was tapered if their disease was still under control by cutting the dosage into half, then into a quarter, and then discontinuing treatment with the agent.

Read on: Gradual TNFi vs csDMARD Tapering in Rheumatoid Arthritis

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