Most patients with rheumatoid arthritis (RA) start out taking the disease-modifying antirheumatic drug (DMARD) methotrexate, but that’s not always enough. The next step is often a biologic drug, such as Humira (adalimumab) or Enbrel (etanercept), which can make a big difference and help move many patients into remission or at least into low disease activity.
But after that happens, do you need to continue taking the same dose of biologics indefinitely, or can you scale back?
According to a new study, people with RA with low disease activity can indeed reduce their dosage of biologics, which can save a substantial amount of money. The research was presented at the 2018 American College of Rheumatology/Association of Rheumatology Health Professionals (ACR/ARHP) Annual Meeting in Chicago.
The study, led by researchers in Belgium, followed 332 RA patients who had been taking a biologic drug for at least one year. Of those, 140 patients ended up achieving low disease activity or remission and were advised to taper their dose of biologic (bDMARD) medication. Another 192 patients continued receiving their regular dose.
Among the group who had tapered their medication, disease activity remained low. (Only 15 patients experienced a flare during the follow-up period.) This confirms that lowering the dose is safe — and that it can result in major cost savings, say the authors.
Although this study primarily focused on maintaining low disease activity and saving money, cutting back on medication would likely translate to fewer side effects as well.
This is not the first study to find that it’s safe for most RA patients with low disease activity to taper their dose of biologics, but some doctors are reluctant to try this approach.
They would likely benefit from seeing even more research on this topic, study coauthor said Patrick Durez, MD, told the American College of Rheumatology in a press release. “The unmet needs for this research are numerous, including the physician’s decision not to follow guidelines addressed by the industry,” he said. “Tapering of biologics is essential in daily care.”
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Get Involved with Patient-Centered Arthritis Research
If you are diagnosed with rheumatoid arthritis or another musculoskeletal health condition, we encourage you to participate in future studies by joining CreakyJoints’ patient research registry, ArthritisPower. ArthritisPower is the first ever patient-led, patient-centered research registry for joint, bone, and inflammatory skin conditions. You can use ArthritisPower to track your disease symptoms, share patterns with your doctor, and participate in voluntary research studies. Learn more here.