Selection of treatment regimens based on shared decision-making in patients with rheumatoid arthritis in remission in the FREE-J study

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Rheumatology (Oxford). February 8, 2022: keac075. doi:10.1093/rheumatology/keac075. Online ahead of print.


OBJECTIVE: To compare the results of various treatment de-escalation regimens in patients with RA who achieved prolonged remission.

METHODS: At Period 1, 436 RA patients treated with MTX and bDMARD and who maintained a DAS28(ESR)

RESULTS: Based on shared decision-making, 81.4% chose treatment de-escalation and 48.4% chose MTX de-escalation. At the end of Period 1, similar proportions of patients maintained a DAS28(ESR)

CONCLUSIONS: After achieving sustained remission with combined MTX/bDMARD therapy, disease control was comparably achieved by continuation, dose reduction, or discontinuation of MTX and dose reduction of bDMARD at the end of year 1. Subsequent MTX de-escalation had no impact on disease control, but decreased adverse events in year 2.

PMID:35136990 | DO I:10.1093/rheumatology/keac075

Martin E. Berry