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The practicability of bDMARDs dose reduction/ tapering in daily practice has been determined in this study.
Previous studies
have described that RA patients with low disease activity or remission are able
to taper bDMARDs. As mentioned in this current analysis, combining bDMARDs with
methotrexate could help achieve bDMARD dose
reduction attempts. Also, etanercept and adalimumab are the most suitable drugs
for dose reduction after low disease activity or remission status is
accomplished.
The practicability of bDMARDs dose reduction/ tapering in daily
practice has been determined in this
study. The dMARDs more appropriate for dose reduction and cost savings have
also been assessed.
The records of 332 eligible
RA patients from Brussels UCLouvain cohort were retrospectively analysed. Out
of these patients, 140 patients were given a tapered dose, and 192 were given constant
doses of bDMARDs.
The age of patient at diagnosis (43.1 versus 38.7 years), health assessment questionnaire (HAQ) score (1.3 versus 1.5), RF positivity rate (83.3 versus 72.9%) and extent of disease at the time of bDMARD initiation (9.7 versus 12.1 years) were notably different between the groups.
Remarkably, more patients receiving a tapered dose were treated with bDMARDs plus methotrexate (MTX) (86.7% versus 73.8%). Anti-TNF agents were found to be most frequently prescribed medications. During follow-up, only 15 patients had a flare. The tapered-dose group had adalimumab (ADA), etanercept (ETA) and rituximab (bDMARDs) which were linked with the most significant declines in annual cost.
In routine
clinical practice, tapering bDMARDs in RA patients who have attained low
disease activity or remission is possible many patients, thus decreasing
potential adverse effects and yearly drug expenditure.
Arthrtis Research & Therapy
Tapering of biological antirheumatic drugs in rheumatoid arthritis patients is achievable and cost-effective in daily clinical practice: data from the Brussels UCLouvain RA Cohort
Stéphanie Dierckx et al.
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