PMC full text:
Published online 2017 Aug 15.
Table 4
Points to be considered for treatment discontinuation/tapering in patients on biologic DMARDs
• Study designs consideration: complete withdrawal or dose tapering or extension of the interval between administrations of biologic DMARDs |
• Any predictors of response following therapy discontinuation or tapering identified |
• Goal of treatment before withdrawal: remission or LDA or other and the definitions used for the goals |
• Duration required for the patients to achieve goal before a given biologic DMARD was discontinued |
• Duration of RA among the enrolled patients |
• Type of prior treatments given to enrolled patients |
• Disease activity level prior to biologic DMARD therapy initiation and the extent of improvement achieved by the therapy before discontinuation |
• Mode of discontinuation of drugs including corticosteroids, NSAIDs and chemical DMARDs which usually accompany biologic DMARDs |
• Criteria of defining success vs. failure of treatment; DAS, simple disease activity index (SDAI), clinical DAI (CDAI), radiological tissue damage assessment or functional status assessed by health assessment questionnaire |
• Follow up duration |
• Effect of treatment resumption; response achieved and the time required for it |
• Incidence of serious flaring such as joint damage and mobility impairment among patients who discontinued or reduced therapy |