Dose adjustments and discontinuation in TNF inhibitors treated patients: when and how. A systematic review of literature

Piero Ruscitti, Luigi Sinigaglia, Massimiliano Cazzato, Rosa Daniela Grembiale, Giovanni Triolo, Ennio Lubrano, Carlomaurizio Montecucco, Roberto Giacomelli

Research output: Contribution to journalArticle

Abstract

Objectives: To review the available evidence concerning the possibility of discontinuing and/or tapering the dosage of TNF inhibitors (TNFi) in RA patients experiencing clinical remission or low disease activity.

Methods: A systematic review of the literature concerning the low dosage and discontinuation of TNFi in disease-controlled RA patients was performed by evaluation of reports published in indexed international journals (Medline via PubMed, EMBASE), in the time frame from 8 April 2013 to 15 January 2016.

Results: We analysed the literature evaluating the efficacy and the safety of two different strategies using TNFi, decreasing dosage or discontinuation, in patients experiencing clinical remission or low disease activity. After the analysis of online databases, 25 references were considered potentially relevant and 16 references were selected. The majority of data concerned etanercept and adalimumab. Results suggested the induction of stable clinical remission or low disease activity by using TNFi followed by a dosage tapering and/or discontinuation of such drugs may be associated with the maintenance of a good clinical response in a subset of patients affected by early disease.

Conclusion: RA patients treated early with TNFi and achieving their therapeutic clinical targets seem to maintain their clinical response after tapering or discontinuing TNFi. These data may allow physicians a more dynamic and tailored management of RA patients.

Original languageEnglish
Pages (from-to)vii23-vii31
JournalRheumatology (Oxford, England)
Volume57
Issue number7
DOIs
Publication statusPublished - Oct 1 2018

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)

Fingerprint Dive into the research topics of 'Dose adjustments and discontinuation in TNF inhibitors treated patients: when and how. A systematic review of literature'. Together they form a unique fingerprint.

  • Cite this