Can biomarkers predict successful tapering of conventional disease-modifying therapy in rheumatoid arthritis patients in stable remission?
Authors' conclusion
In the tapering group, the combination of clinical, PRO, US and T-cell parameters demonstrated added value for predicting sustained remission compared with clinical parameters alone.
Study context
- Population
- RA patients with 3v-DAS28CRP<2.6 for ≥6 months on stable csDMARD therapy
- Participants
- 117 vs 83
- Exposure
- Structured csDMARD tapering vs continued stable csDMARD therapy
- Taperingn = 117
- Stable treatmentn = 83reference
- Outcome
- Proportion of patients in sustained remission without relapse
- Follow-up
- 12 months
Methodological detailsstructured cs-DMARD tapering vs continued therapy (patient choice), regression analyses
- Structured cs-DMARD tapering vs continued therapy (patient choice)
- Regression analyses
Main finding
As reported in the abstract
Clinical remission
P = 0.018
Observational data: associations, not effects.
Further findings
Predictors of flare in Tapering
- Higher CRP, TJC, % inflammation-related T-cells (IRC) and patient-reported outcome (PROs) associated with flare
- all p<0.05
- Trend for total PD
- P = 0.066
Model predicting sustained remission in Tapering (RAQoL, total PD, IRC)
- Accuracy
- 85%
- AUROC
- 0.893
- P
- P < 0.0001
Predictors of flare in Stable treatment
- Higher CRP, ESR, SJC and shorter disease duration associated with flare
- all p<0.05
- No parameter able to predict sustained remission
Original publication
Can biomarkers predict successful tapering of conventional disease-modifying therapy in rheumatoid arthritis patients in stable remission? Clin Exp Rheumatol. Published 23 January 2022. doi:10.
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