To taper or not to taper biological disease-modifying antirheumatic drugs in axial spondyloarthritis anno 2023: That is the question

IF 4.5 2区 医学 Q1 RHEUMATOLOGY Best Practice & Research in Clinical Rheumatology Pub Date : 2023-09-01 DOI:10.1016/j.berh.2023.101869
Zuzanna Lukasik , Philippe Carron , Casper Webers
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Abstract

The 2022 ASAS-EULAR recommendations for the management of axial spondyloarthritis (axSpA) propose to consider dose reduction of biological disease-modifying antirheumatic drugs (bDMARDs) for patients in sustained remission. However, this recommendation does not offer clear guidance for daily clinical practice. In this review, we analyze randomized clinical trials and real-world data on tapering and discontinuation of bDMARDs in patients with axSpA. We discuss the scientific rationale and benefits of tapering, identify advice to apply tapering in current practice, and delineate aspects to be investigated in future research.

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2023年,轴性脊柱关节炎的生物修饰抗风湿药该减量还是不该减量?这是一个问题
2022年ASAS-EULAR关于轴性脊柱关节炎(axSpA)治疗的建议提出,对于病情持续缓解的患者,可考虑减少生物修饰抗风湿药(bDMARDs)的剂量。然而,这一建议并未为日常临床实践提供明确指导。在本综述中,我们分析了有关 axSpA 患者减量和停用 bDMARDs 的随机临床试验和实际数据。我们讨论了减量的科学依据和益处,确定了在当前实践中应用减量的建议,并划定了未来研究中需要调查的方面。
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来源期刊
CiteScore
9.40
自引率
0.00%
发文量
43
审稿时长
27 days
期刊介绍: Evidence-based updates of best clinical practice across the spectrum of musculoskeletal conditions. Best Practice & Research: Clinical Rheumatology keeps the clinician or trainee informed of the latest developments and current recommended practice in the rapidly advancing fields of musculoskeletal conditions and science. The series provides a continuous update of current clinical practice. It is a topical serial publication that covers the spectrum of musculoskeletal conditions in a 4-year cycle. Each topic-based issue contains around 200 pages of practical, evidence-based review articles, which integrate the results from the latest original research with current clinical practice and thinking to provide a continuous update. Each issue follows a problem-orientated approach that focuses on the key questions to be addressed, clearly defining what is known and not known. The review articles seek to address the clinical issues of diagnosis, treatment and patient management. Management is described in practical terms so that it can be applied to the individual patient. The serial is aimed at the physician in both practice and training.
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