Tapering biologics in rheumatoid arthritis: a pragmatic approach for clinical practice

Clinical Rheumatology

Volumn 36, Issue 1, 2017, Pages 1-8

  Lenert, Aleksander ^a   Lenert, Petar ^b  

^a UNIVERSITY OF KENTUCKY   (United States)

^b UNIVERSITY OF IOWA   (United States)

Author keywords

Biologic therapy; Discontinuation; Musculoskeletal ultrasound; Rheumatoid arthritis; Tapering; Treat to target

Indexed keywords

ABATACEPT; ADALIMUMAB; CERTOLIZUMAB PEGOL; DISEASE MODIFYING ANTIRHEUMATIC DRUG; ETANERCEPT; INFLIXIMAB; TOCILIZUMAB; TUMOR NECROSIS FACTOR ANTIBODY; ANTIRHEUMATIC AGENT; BIOLOGICAL PRODUCT; IMMUNOSUPPRESSIVE AGENT; MONOCLONAL ANTIBODY; TNF PROTEIN, HUMAN; TUMOR NECROSIS FACTOR;

ARTICLE; BIOLOGICAL THERAPY; CLINICAL PRACTICE; DISEASE ACTIVITY; DISEASE CONTROL; HUMAN; IMMUNOSUPPRESSIVE TREATMENT; PRACTICE GUIDELINE; PRIORITY JOURNAL; RADIOGRAPHY; RETREATMENT; RHEUMATOID ARTHRITIS; RHEUMATOLOGY; ANTAGONISTS AND INHIBITORS; ARTHRITIS, RHEUMATOID; DIAGNOSTIC IMAGING; DRUG ADMINISTRATION; ECHOGRAPHY; PROCEDURES; SKELETAL MUSCLE;

ABATACEPT; ADALIMUMAB; ANTIBODIES, MONOCLONAL, HUMANIZED; ANTIRHEUMATIC AGENTS; ARTHRITIS, RHEUMATOID; BIOLOGICAL PRODUCTS; CERTOLIZUMAB PEGOL; DRUG ADMINISTRATION SCHEDULE; ETANERCEPT; HUMANS; IMMUNOSUPPRESSIVE AGENTS; INFLIXIMAB; MUSCLE, SKELETAL; RHEUMATOLOGY; TUMOR NECROSIS FACTOR-ALPHA; ULTRASONOGRAPHY;

EID: 84997765915     PISSN: 07703198     EISSN: 14349949     Source Type: Journal    
DOI: 10.1007/s10067-016-3490-8     Document Type: Article

References (34)

1. Spector TD (1990) Rheumatoid arthritis. Rheum Dis Clin N Am 16(3):513–537
2. Lee DM, Weinblatt ME (2001) Rheumatoid arthritis. Lancet 358(9285):903–911. doi:10.1016/s0140-6736(01)06075-5
3. McInnes IB, Liew FY (2005) Cytokine networks—towards new therapies for rheumatoid arthritis. Nat Clin Pract Rheumatol 1(1):31–39. doi:10.1038/ncprheum0020
4. Perricone C, Ceccarelli F, Valesini G (2011) An overview on the genetic of rheumatoid arthritis: a never-ending story. Autoimmun Rev 10(10):599–608. doi:10.1016/j.autrev.2011.04.021
5. Jutley G, Raza K, Buckley CD (2015) New pathogenic insights into rheumatoid arthritis. Curr Opin Rheumatol 27(3):249–255. doi:10.1097/bor.0000000000000174
6. Yarwood A, Huizinga TW, Worthington J (2016) The genetics of rheumatoid arthritis: risk and protection in different stages of the evolution of RA. Rheumatology (Oxford) 55(2):199–209. doi:10.1093/rheumatology/keu323
7. Singh JA, Saag KG, Bridges SL Jr et al (2016) 2015 American College of Rheumatology Guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol 68(1):1–26. doi:10.1002/art.39480
8. Smolen JS, Landewe R, Breedveld FC et al (2014) EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 update. Ann Rheum Dis 73(3):492–509. doi:10.1136/annrheumdis-2013-204573
9. Fautrel B, Den Broeder AA (2015) De-intensifying treatment in established rheumatoid arthritis (RA): why, how, when and in whom can DMARDs be tapered? Best Pract Res Clin Rheumatol 29(4–5):550–565. doi:10.1016/j.berh.2015.09.006
10. Tanaka Y, Hirata S, Saleem B, Emery P (2013) Discontinuation of biologics in patients with rheumatoid arthritis. Clin Exp Rheumatol 31(4 Suppl 78):S22–S27
11. Pouw MF, Krieckaert CL, Nurmohamed MT, van der Kleij D, Aarden L, Rispens T, Wolbink G (2015) Key findings towards optimising adalimumab treatment: the concentration-effect curve. Ann Rheum Dis 74(3):513–518. doi:10.1136/annrheumdis-2013-204172
12. Betegnie AL, Gauchet A, Lehmann A et al (2016) Why do patients with chronic inflammatory rheumatic diseases discontinue their biologics? An assessment of patients’ adherence using a self-report questionnaire. J Rheumatol 43(4):724–730. doi:10.3899/jrheum.150414
13. Detert J, Bastian H, Listing J et al (2013) Induction therapy with adalimumab plus methotrexate for 24 weeks followed by methotrexate monotherapy up to week 48 versus methotrexate therapy alone for DMARD-naive patients with early rheumatoid arthritis: HIT HARD, an investigator-initiated study. Ann Rheum Dis 72(6):844–850. doi:10.1136/annrheumdis-2012-201612
14. Kavanaugh A, Fleischmann RM, Emery P et al (2013) Clinical, functional and radiographic consequences of achieving stable low disease activity and remission with adalimumab plus methotrexate or methotrexate alone in early rheumatoid arthritis: 26-week results from the randomised, controlled OPTIMA study. Ann Rheum Dis 72(1):64–71. doi:10.1136/annrheumdis-2011-201247
15. Tanaka Y, Yamanaka H, Ishiguro N, Miyasaka N, Kawana K, Hiramatsu K, Takeuchi T (2016) Adalimumab discontinuation in patients with early rheumatoid arthritis who were initially treated with methotrexate alone or in combination with adalimumab: 1 year outcomes of the HOPEFUL-2 study. RMD Open 2(1):e000189. doi:10.1136/rmdopen-2015-000189
16. Tanaka Y, Hirata S, Kubo S et al (2015) Discontinuation of adalimumab after achieving remission in patients with established rheumatoid arthritis: 1-year outcome of the HONOR study. Ann Rheum Dis 74(2):389–395. doi:10.1136/annrheumdis-2013-204016
17. Chatzidionysiou K, Turesson C, Teleman A et al (2016) A multicentre, randomised, controlled, open-label pilot study on the feasibility of discontinuation of adalimumab in established patients with rheumatoid arthritis in stable clinical remission. RMD Open 2(1):e000133. doi:10.1136/rmdopen-2015-000133
18. Moghadam MG, Vonkeman HE, Ten Klooster PM et al (2016) Stopping tumor necrosis factor inhibitor treatment in patients with established rheumatoid arthritis in remission or with stable low disease activity: a pragmatic multicenter, open-label randomized controlled trial. Arthritis Rheumatol 68(8):1810–1817. doi:10.1002/art.39626
19. Emery P, Hammoudeh M, FitzGerald O et al (2014) Sustained remission with etanercept tapering in early rheumatoid arthritis. N Engl J Med 371(19):1781–1792. doi:10.1056/NEJMoa1316133
20. Smolen JS, Nash P, Durez P et al (2013) Maintenance, reduction, or withdrawal of etanercept after treatment with etanercept and methotrexate in patients with moderate rheumatoid arthritis (PRESERVE): a randomised controlled trial. Lancet 381(9870):918–929. doi:10.1016/s0140-6736(12)61811-x
21. van Vollenhoven RF, Ostergaard M, Leirisalo-Repo M et al (2016) Full dose, reduced dose or discontinuation of etanercept in rheumatoid arthritis. Ann Rheum Dis 75(1):52–58. doi:10.1136/annrheumdis-2014-205726
22. van Herwaarden N, van der Maas A, Minten MJ et al (2015) Disease activity guided dose reduction and withdrawal of adalimumab or etanercept compared with usual care in rheumatoid arthritis: open label, randomised controlled, non-inferiority trial. BMJ 350:h1389. doi:10.1136/bmj.h1389
23. Fautrel B, Pham T, Alfaiate T et al (2016) Step-down strategy of spacing TNF-blocker injections for established rheumatoid arthritis in remission: results of the multicentre non-inferiority randomised open-label controlled trial (STRASS: Spacing of TNF-blocker injections in Rheumatoid ArthritiS Study). Ann Rheum Dis 75(1):59–67. doi:10.1136/annrheumdis-2014-206696
24. van den Broek M, Klarenbeek NB, Dirven L et al (2011) Discontinuation of infliximab and potential predictors of persistent low disease activity in patients with early rheumatoid arthritis and disease activity score-steered therapy: subanalysis of the BeSt study. Ann Rheum Dis 70(8):1389–1394. doi:10.1136/ard.2010.147751
25. Schett G, Emery P, Tanaka Y et al (2016) Tapering biologic and conventional DMARD therapy in rheumatoid arthritis: current evidence and future directions. Ann Rheum Dis 75(8):1428–1437. doi:10.1136/annrheumdis-2016-209201
26. Smolen JS, Emery P, Ferraccioli GF et al (2015) Certolizumab pegol in rheumatoid arthritis patients with low to moderate activity: the CERTAIN double-blind, randomised, placebo-controlled trial. Ann Rheum Dis 74(5):843–850. doi:10.1136/annrheumdis-2013-204632
27. Emery P, Burmester GR, Bykerk VP et al (2015) Evaluating drug-free remission with abatacept in early rheumatoid arthritis: results from the phase 3b, multicentre, randomised, active-controlled AVERT study of 24 months, with a 12-month, double-blind treatment period. Ann Rheum Dis 74(1):19–26. doi:10.1136/annrheumdis-2014-206106
28. Westhovens R, Robles M, Ximenes AC et al (2015) Maintenance of remission following 2 years of standard treatment then dose reduction with abatacept in patients with early rheumatoid arthritis and poor prognosis. Ann Rheum Dis 74(3):564–568. doi:10.1136/annrheumdis-2014-206149
29. Takeuchi T, Matsubara T, Ohta S et al (2015) Biologic-free remission of established rheumatoid arthritis after discontinuation of abatacept: a prospective, multicentre, observational study in Japan. Rheumatology (Oxford) 54(4):683–691. doi:10.1093/rheumatology/keu338
30. Nishimoto N, Amano K, Hirabayashi Y et al (2014) Drug free REmission/low disease activity after cessation of tocilizumab (Actemra) Monotherapy (DREAM) study. Mod Rheumatol 24(1):17–25. doi:10.3109/14397595.2013.854079
31. Nishimoto N, Amano K, Hirabayashi Y et al (2014) Retreatment efficacy and safety of tocilizumab in patients with rheumatoid arthritis in recurrence (RESTORE) study. Mod Rheumatol 24(1):26–32. doi:10.3109/14397595.2013.854080
32. Iwamoto T, Ikeda K, Hosokawa J et al (2014) Prediction of relapse after discontinuation of biologic agents by ultrasonographic assessment in patients with rheumatoid arthritis in clinical remission: high predictive values of total gray-scale and power Doppler scores that represent residual synovial inflammation before discontinuation. Arthritis Care Res (Hoboken) 66(10):1576–1581. doi:10.1002/acr.22303
33. Naredo E, Valor L, De la Torre I et al (2015) Predictive value of Doppler ultrasound-detected synovitis in relation to failed tapering of biologic therapy in patients with rheumatoid arthritis. Rheumatology (Oxford) 54(8):1408–1414. doi:10.1093/rheumatology/kev006
34. Alivernini S, Peluso G, Fedele AL, Tolusso B, Gremese E, Ferraccioli G (2016) Tapering and discontinuation of TNF-alpha blockers without disease relapse using ultrasonography as a tool to identify patients with rheumatoid arthritis in clinical and histological remission. Arthritis Res Ther 18:39. doi:10.1186/s13075-016-0927-z