Discontinuation versus continuation of maintenance treatment with tumor necrosis factor inhibitors in patients with rheumatoid arthritis with low disease activity or remission: A randomized double-blind placebo-controlled trial
Primary result · RelapseResult — go to the resultHazard ratio 4.88 95 % CI 2.05–11.61- stopped early after interim analysis
- Stopped early based on an interim analysis that rejected noninferiority
Authors' conclusion
Discontinuation of maintenance TNFi resulted in higher rates of relapse of RA than continuation.
Study context
- Population
- Adults with rheumatoid arthritis (RA) treated with adalimumab, etanercept, or infliximab with DAS-CRP < 2.6 for at least six monthsrandomised 2:1
- Participants
- 102 adults
- Comparison
- Discontinuation of tumor necrosis factor inhibitor (TNFi) vs continuation of active TNFi
- Primary endpoint
- Relapse, defined as DAS29-CRP ≥ 2.6 or treatment escalation
- Follow-up
- 48 weeks
Methodological detailsdouble-blind, placebo-controlled, noninferiority
- Double-blind
- Placebo-controlled
- Noninferiority
Primary result
Relapse
Hazard ratio
4.88
95 % CI 2.05–11.61
By group
Placebovs Active TNFi
HR 4.88 (95 % CI 2.05–11.61)
As reported in the abstract
Secondary outcomes
Flare (increase in DAS28-CRP ≥ 1.2 from baseline)
Successful discontinuation by discontinued TNFi (subgroup) · 48 weeks
%
- Discontinued adalimumab
- 55
- Discontinued etanercept
- 26
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Discontinuation versus continuation of maintenance treatment with tumor necrosis factor inhibitors in patients with rheumatoid arthritis with low disease activity or remission: A randomized double-blind placebo-controlled trial. Semin Arthritis Rheum. Published 17 September 2025. doi:10.
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