A new study investigates three treatment options for patients with rheumatoid arthritis in stable remission, to help prevent overtreatment

Rheumatoid arthritis

Reducing or stopping antirheumatic drugs in patients with rheumatoid arthritis in stable remission is a feasible strategy, however, it requires tight monitoring of disease activity, according to the results of the RETRO clinical trial.

The study, published in The Lancet Rheumatology, enrolled 303 adult patients with rheumatoid arthritis who were in sustained remission according to the disease activity score using 28 joints (DAS28) with erythrocyte sedimentation rate. The participants were randomly assigned to continue 100% of dose medication (n=100), taper to 50% dose (n=102), or stop medication (n=101).

The final analysis included 282 patients. Remission was maintained at 12 months in 81.2% in the continue group, 58.6% in the taper group, and 43.3% in the stop group. Patients more likely to relapse after tapering or stopping their treatment were:

  • female
  • those with longer disease duration
  • seropositivity for rheumatoid factor, or anti-citrullinated protein antibody-positive rheumatoid arthritis, or both
  • baseline treatment with biologics
  • higher baseline DAS28 scores. 

The majority of the patients who relapsed regained remission after restarting their treatments. These results might help to prevent overtreatment in a substantial number of patients with rheumatoid arthritis.

This article originally appeared on Univadis, part of the Medscape Professional Network. 

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