Disease activity–guided dose optimization including discontinuation of TNF inhibitors in rheumatoid arthritis is effective for up to 10 years: an observational follow-up of the DRESS study
Authors' conclusion
Long-term disease activity-guided dose optimization of TNF inhibitors in RA, including discontinuation and multiple tapering attempts, remains safe and effective.
Study context
- Population
- Patients with RA on TNF inhibitors who completed the 3-year extension of the DRESS study127 completed 10-year follow-up
- Participants
- 170 patients
- Primary endpoint
- Main outcomes: mean time-weighted DAS28-CRP; b/tsDMARD use per year as proportion of daily defined dose; proportion reaching discontinuation; durability and effectiveness of subsequent dose reduction attempts; radiographic progression (Sharp-van der Heijde score) between years 3 and 10
- Follow-up
- 10 years
Methodological detailsobservational follow-up, 10-year follow-up
- Observational follow-up
- 10-year follow-up
Primary result
As reported in the abstract
- Mean time-weighted DAS28-CRP
- 2.13 (95% CI 2.10-2.16)
- b/tsDMARD dose (% of daily defined dose) at baseline, n = 170
- 97% (95% CI 96-99%)
- b/tsDMARD dose (% of daily defined dose) at year 10, n = 127
- 56% (95% CI 49-63%)
- Reached discontinuation, of 161 with an optimization attempt
- 119 (74%)
- Median duration of discontinuation
- 7 months (IQR 3-33 months)
- Never had to restart b/tsDMARD
- 25 (21%, 95% CI 14-29%)
- Mean dose reduction, first optimization attempt (n = 159)
- 48%
- Mean dose reduction, subsequent attempt (n = 86)
- 33%
- Radiographic progression exceeding smallest detectable change (5.7 units), of 86
- 41 (48%)
Original publication
Disease activity–guided dose optimization including discontinuation of TNF inhibitors in rheumatoid arthritis is effective for up to 10 years: an observational follow-up of the DRESS study. Rheumatology (Oxford). Published 12 February 2024. doi:10.
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