Gradual tapering TNF inhibitors versus conventional synthetic DMARDs after achieving controlled disease in patients with rheumatoid arthritis: first-year results of the randomised controlled TARA study

Elise Van Mulligen,Joop B Harbers,Yael De Man,T H Esmeralda Molenaar,Jende Van Zeben,Johanna M W Hazes,Myrthe Van Der Ven,Pascal Hendrik Pieter De Jong,Casper Bijkerk,Jolanda J Luime,Ilja Tchetverikov,Cathelijne Appels,Tjallingius Martijn Kuijper,Yvonne P M Goekoop-Ruiterman,Angelique E A M Weel

doi:10.1136/annrheumdis-2018-214970

Abstract

ObjectivesThe aim of this study is to evaluate the effectiveness of two tapering strategies after achieving controlled disease in patients with rheumatoid arthritis (RA), during 1 year of follow-up.MethodsIn this...

Highlights

Treatment outcomes of rheumatoid arthritis (RA) have improved enormously during the past decades due to earlier detection of the disease, a treat-to-target approach and intensified treatment, especially combination therapy with Key messagesWhat is already known about this subject? ►► With better treatment outcomes, it is nowadays common to taper medication in patients with rheumatoid arthritis who are in sustained remission
What does this study add? ►► This study compares the effectiveness of gradual tapering the conventional synthetic disease-modifying antirheumatic drugs or the tumor necrosis factor (TNF) inhibitor in patients with rheumatoid arthritis with controlled disease treated with a combination of csDMARDs and a TNF inhibitor. ►► The TApering strategies in Rheumatoid Arthritis (TARA) trial is one of the first trials which assesses differences in tapering strategies, and elaborates on current viewpoints concerning tapering treatment, instead of only determining if tapering is feasible or not
Patients A total of 330 patients were assessed for eligibility and 189 of those were randomly assigned to tapering their csDMARD (n=94) or tapering their TNF inhibitor (n=95)

Summary

Introduction

Treatment outcomes of rheumatoid arthritis (RA) have improved enormously during the past decades due to earlier detection of the disease, a treat-to-target approach and intensified treatment, especially combination therapy with Key messagesWhat is already known about this subject? ►► With better treatment outcomes, it is nowadays common to taper medication in patients with rheumatoid arthritis who are in sustained remission. ►► The TApering strategies in Rheumatoid Arthritis (TARA) trial is one of the first trials which assesses differences in tapering strategies, and elaborates on current viewpoints concerning tapering treatment, instead of only determining if tapering is feasible or not. ►► This study compares the effectiveness of gradual tapering the conventional synthetic disease-modifying antirheumatic drugs (csDMARD) or the TNF inhibitor in patients with rheumatoid arthritis with controlled disease treated with a combination of csDMARDs and a TNF inhibitor.

Objectives

Methods

Results

Conclusion