ARTIC REWIND - Don't Stop The TNF Inhibitor - Dr. Kathryn Dao Save
Dr. Kathryn Dao from EULAR2020 Virtual Conference
Transcription
This is doctor Katherine Dow reporting for RheumNow. I'm at ULAAR twenty twenty, and I wanna share with you a study that I think is gonna impact your clinical practice. This is the ARTIC REWIND trial. This is a multicenter, multinational, government funded study seeking to answer the question, can you withdraw a TNF inhibitor in a patient with rheumatoid arthritis who's been in remission for at least one year? So the study randomized ninety nine patients, and these patients demographics include being in DAS twenty eight remission for one year, no tender, no swollen joints, SED rate and CRP completely normal, and no Doppler signal of inflammation in their joints.
Half of the patients were randomized to taper off their TNF inhibitors in four months. The other half continued their TNF inhibitors. And the study went on for one year, and what they observed was that the patients who tapered off their TNF inhibitors significantly had more flares compared to patients who continued their TNF inhibitors. Fifty three percent of patients who tapered off FLAIR compared to five percent who continue TNF inhibitors. The study investigators also allowed the protocol to reinitiate TNF inhibitors in those with significant flares.
And when these patients reinitiated their TNF inhibitors, they were able to achieve remission again. At the end of one year, there was no difference in radiographic damage scores. What they also found were that the patients who continued TNF inhibitors, no increased serious adverse events, no serious, infectious events. Although the patients who withdrew their TNF inhibitors had a little bit less in minor infections. So in patients who are in remission, it was recommended to go ahead and continue their TNF inhibitors rather than to withdraw the TNF inhibitors.
This is doctor Katherine Dow reporting.
Half of the patients were randomized to taper off their TNF inhibitors in four months. The other half continued their TNF inhibitors. And the study went on for one year, and what they observed was that the patients who tapered off their TNF inhibitors significantly had more flares compared to patients who continued their TNF inhibitors. Fifty three percent of patients who tapered off FLAIR compared to five percent who continue TNF inhibitors. The study investigators also allowed the protocol to reinitiate TNF inhibitors in those with significant flares.
And when these patients reinitiated their TNF inhibitors, they were able to achieve remission again. At the end of one year, there was no difference in radiographic damage scores. What they also found were that the patients who continued TNF inhibitors, no increased serious adverse events, no serious, infectious events. Although the patients who withdrew their TNF inhibitors had a little bit less in minor infections. So in patients who are in remission, it was recommended to go ahead and continue their TNF inhibitors rather than to withdraw the TNF inhibitors.
This is doctor Katherine Dow reporting.
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