Patient-individual tapering of DMARDs in rheumatoid arthritis patients in a real-world setting
Authors' conclusion
Individual tapering of DMARDs does not increase the average risk of experiencing flares or loss of remission.
Study context
- Population
- RA patients in sustained remission (>6 months) eligible for tapering at enrolment, daily clinical practice, Germany, July 2018 to March 2021
- Participants
- 200 vs 237
- Exposure
- Patient-individual tapering of DMARDs based on shared decision making vs continuation without dose reduction
- Individual taperingn = 200
- Continuationn = 237reference
- Outcome
- Risk of flare and risk of loss of remission
Methodological detailscontrolled, risk-adjusted Kaplan-Meier estimators and Cox regressions
- Controlled
- Risk-adjusted Kaplan-Meier estimators and Cox regressions
Main finding
As reported in the abstract
Each group vs continuationEstimate (95% CI)
Individual tapering
HR (flare) 0.88(0.59–1.30)
Individual tapering
HR (loss of remission) 1.04(0.73–1.49)
Observational data: associations, not effects.
Further findings
| Outcome | Individual tapering | Continuation | P value |
|---|---|---|---|
| Change in drug costs, 1 year before vs after baseline (claims data subgroup, n = 76) | 1017€ | 1151€ | P < 0.01 |
| Direction | decreased | increased |
Disease activity and quality of life · 12 months after baseline
- Minor increases of disease activity and decreases of quality of life, with no statistically significant difference between groups
Original publication
Patient-individual tapering of DMARDs in rheumatoid arthritis patients in a real-world setting. Rheumatology (Oxford). Published 18 August 2022. doi:10.
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