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Key clinical point: Patients with rheumatoid arthritis (RA) in long-standing remission had a significant risk of experiencing a disease flare if the tumor necrosis factor inhibitor (TNFi) dose is tapered to discontinuation, but most patients regained remission after the original TNFi dose was reinstated.
Major finding: The frequency of disease activity flares during the 12-month follow-up was significantly higher among patients who tapered TNFi to discontinuation vs those who continued with the stable dose (risk difference 58%; P < .0001). However, reinstatement of the initial TNFi dose led to comparable remission rates in both treatment groups.
Study details: Findings are from the phase 4 ARCTIC REWIND trial including 92 patients with RA in sustained remission for ≥ 1 year on stable TNFi therapy and without swollen joints at inclusion, who were randomly assigned to either tapering of their TNFi dose to discontinuation or to a continued stable TNFi dose.
Disclosures: This study was funded by the Research Council of Norway and South-Eastern Norway Regional Health Authority. Some authors declared receiving personal fees or grants from various sources, including the study funders.
Source: Lillegraven S et al. Effect of tapered versus stable treatment with tumour necrosis factor inhibitors on disease flares in patients with rheumatoid arthritis in remission: A randomised, open label, non-inferiority trial. Ann Rheum Dis. 2023 (Aug 22). doi: 10.1136/ard-2023-224476
Key clinical point: Patients with rheumatoid arthritis (RA) in long-standing remission had a significant risk of experiencing a disease flare if the tumor necrosis factor inhibitor (TNFi) dose is tapered to discontinuation, but most patients regained remission after the original TNFi dose was reinstated.
Major finding: The frequency of disease activity flares during the 12-month follow-up was significantly higher among patients who tapered TNFi to discontinuation vs those who continued with the stable dose (risk difference 58%; P < .0001). However, reinstatement of the initial TNFi dose led to comparable remission rates in both treatment groups.
Study details: Findings are from the phase 4 ARCTIC REWIND trial including 92 patients with RA in sustained remission for ≥ 1 year on stable TNFi therapy and without swollen joints at inclusion, who were randomly assigned to either tapering of their TNFi dose to discontinuation or to a continued stable TNFi dose.
Disclosures: This study was funded by the Research Council of Norway and South-Eastern Norway Regional Health Authority. Some authors declared receiving personal fees or grants from various sources, including the study funders.
Source: Lillegraven S et al. Effect of tapered versus stable treatment with tumour necrosis factor inhibitors on disease flares in patients with rheumatoid arthritis in remission: A randomised, open label, non-inferiority trial. Ann Rheum Dis. 2023 (Aug 22). doi: 10.1136/ard-2023-224476
Key clinical point: Patients with rheumatoid arthritis (RA) in long-standing remission had a significant risk of experiencing a disease flare if the tumor necrosis factor inhibitor (TNFi) dose is tapered to discontinuation, but most patients regained remission after the original TNFi dose was reinstated.
Major finding: The frequency of disease activity flares during the 12-month follow-up was significantly higher among patients who tapered TNFi to discontinuation vs those who continued with the stable dose (risk difference 58%; P < .0001). However, reinstatement of the initial TNFi dose led to comparable remission rates in both treatment groups.
Study details: Findings are from the phase 4 ARCTIC REWIND trial including 92 patients with RA in sustained remission for ≥ 1 year on stable TNFi therapy and without swollen joints at inclusion, who were randomly assigned to either tapering of their TNFi dose to discontinuation or to a continued stable TNFi dose.
Disclosures: This study was funded by the Research Council of Norway and South-Eastern Norway Regional Health Authority. Some authors declared receiving personal fees or grants from various sources, including the study funders.
Source: Lillegraven S et al. Effect of tapered versus stable treatment with tumour necrosis factor inhibitors on disease flares in patients with rheumatoid arthritis in remission: A randomised, open label, non-inferiority trial. Ann Rheum Dis. 2023 (Aug 22). doi: 10.1136/ard-2023-224476