Tapering biologic and conventional DMARD therapy in rheumatoid arthritis: current evidence and future directions.

Published

Journal Article (Review)

Improvements in the control of inflammation in rheumatoid arthritis (RA) by conventional synthetic and biologic disease-modifying antirheumatic drugs (DMARDs) have led to a substantial change in the clinical outcomes of patients during the last 30 years. Current treatment can lead to sustained remission in some patients raising questions about the optimal management strategies in this subgroup of patients. Today, tapering of DMARDs and even their discontinuation appears as an interesting concept for achieving a more tailored and dynamic treatment approach of RA, especially in patients, who achieved full disease control by DMARD treatment. In this review article, current developments of DMARD tapering are discussed. The article provides an overview of existing studies on this topic and addresses new strategies to reach drug-free remission. Furthermore, concepts for defining patients eligible for DMARD tapering are described and potential future strategies in using biomarkers in predicting the risk for disease relapse after initiation of DMARD tapering are addressed. These findings are finally considered in light of the vision to achieve cure as an ultimate goal in patients with RA achieving full control of inflammation.

Full Text

Duke Authors

Cited Authors

  • Schett, G; Emery, P; Tanaka, Y; Burmester, G; Pisetsky, DS; Naredo, E; Fautrel, B; van Vollenhoven, R

Published Date

  • August 2016

Published In

Volume / Issue

  • 75 / 8

Start / End Page

  • 1428 - 1437

PubMed ID

  • 27261493

Pubmed Central ID

  • 27261493

Electronic International Standard Serial Number (EISSN)

  • 1468-2060

Digital Object Identifier (DOI)

  • 10.1136/annrheumdis-2016-209201

Language

  • eng

Conference Location

  • England