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ARTIC REWIND - Don't Half DMARD Therapy

May 06, 2021 8:51 am

The ARTIC-REWIND study examined rheumatoid arthritis (RA) patients in remission on conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) to see if they could "step-down" their csDMARDs theray; but  the study showed that 25% those who went on half-dose experienced disease flares (less so in the stable-dose group).

A total of 160 RA patients in remission for 12 months who were randomized to either receive half-dose csDMARDs or stable-dose csDMARDs for 12 months. The primary end point was the proportion of patients with a disease flares. 

RA flares occurred in 25% in the half-dose csDMARD group compared with 6% in the stable-dose csDMARD group (risk difference, 18% [95% CI, 7%-29%]).

Adverse events were seen in 44% vs 54%, respectively, with none leading to discontinuation. 

The findings of this well designed step down trial do not changing patients to half-dose therapy.

The author has no conflicts of interest to disclose related to this subject

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