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

Zuzanna Lukasik; Philippe Carron; Casper Webers

doi:10.1016/j.berh.2023.101869

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

Best Pract Res Clin Rheumatol. 2023 Sep;37(3):101869. doi: 10.1016/j.berh.2023.101869. Epub 2023 Aug 30.

Authors

Zuzanna Lukasik¹, Philippe Carron², Casper Webers³

Affiliations

¹ Department of Internal Medicine and Pediatrics, Ghent University, Ghent University Hospital, Ghent, Belgium; VIB Center for Inflammation Research, Ghent, Belgium.
² Department of Internal Medicine and Pediatrics, Ghent University, Ghent University Hospital, Ghent, Belgium; VIB Center for Inflammation Research, Ghent, Belgium. Electronic address: philippe.carron@ugent.be.
³ Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre+, Maastricht, the Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.

PMID: 37658017
DOI: 10.1016/j.berh.2023.101869

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.

Keywords: Axial spondyloarthritis; Biological DMARD; Discontinuation; Remission; Tapering; Therapy.

Publication types

Review

MeSH terms

Antirheumatic Agents* / therapeutic use
Axial Spondyloarthritis*
Humans
Spondylarthritis* / drug therapy
Spondylitis, Ankylosing* / drug therapy

Substances

Antirheumatic Agents