Tapering of disease-modifying antirheumatic drugs: an overview for daily practice

Author(s):
Maassen, J.M. (0000-0002-9591-5398); Ouwerkerk, L. van (0000-0001-8036-950X); Aliaart, C.F.
Published
2021
Publication type
Article / Letter to editor

Abstract

In this Review, we discuss the possibility of drug tapering in patients with rheumatoid arthritis in remission or

low disease activity, for glucocorticoids and disease-modifying antirheumatic drugs. We review international

guidelines and recommendations, as well as remaining uncertainties, and provide an overview of the current

literature. Three strategies of tapering are discussed: (1) tapering by discontinuation of one of the drugs in combination therapy regimens, (2) tapering by reducing the dose of one of the drugs in combination therapy regimens, and (3) tapering by dose reduction of monotherapy with disease-modifying antirheumatic drugs. We discuss the outcomes and robustness of evidence of trials and observational cohorts, and we give a trajectory for further research and drug tapering in daily practice.

Date issued
2021-09-01
Language
English
Publisher
Elsevier Ltd
Is part of
The Lancet Rheumatology (2021), Vol. 3, no. 9, p. 659-670
hdl
1887/3769449
doi
10.1016/S2665-9913(21)00224-1