Stepwise dose reduction and discontinuation of bDMARD in rheumatoid arthritis: a prospective cohort study of flare-free population, flares, and predictive markers.

ABSTRACT:

Background

This study investigated the clinical outcomes of stepwise dose-reduction and discontinuation protocols for biological disease-modifying anti-rheumatic drugs (bDMARD) in patients with stable rheumatoid arthritis (RA), and explored predictors of disease flares.

Methods

Seventy-one patients in clinical remission for ≥ 6 months were enrolled in the Reduction group. In Phase 1, dosing intervals were extended to 1.5 and then 2.0 times the standard schedule for patients who maintained low disease activity (LDA) for ≥ 12 months. Patients who sustained LDA (n = 41) advanced to Phase 2 for complete bDMARD discontinuation. Seventy-one matched patients who continued standard therapy served as controls.

Results

In Phase 1, 12-month flare-free population rates were 80.6%

SUBMITTER: Nozaki Y 

PROVIDER: S-EPMC12584375 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature