Efficacy of tapering biologics and JAK inhibitors in rheumatoid arthritis: A systematic review and meta-analysis.

What was studied

This review looked at what happens when people with rheumatoid arthritis taper their drugs. The drugs were anti-TNF drugs, JAK inhibitors and tocilizumab. Randomized trials compared tapering with standard treatment. The review pooled 2782 patients. People were followed from 6 months up to 3.5 years. The review was registered ahead of time.

What they found

Tapering anti-TNF did not change low disease activity. It made remission less likely and flare-ups more likely. Tapering JAK inhibitors made low disease activity and remission less likely. Flares came more often and earlier. Tapering tocilizumab also made low activity or remission less likely. It also led to more flares.

What it means for patients

The authors say routine tapering of these drugs should not be done for all patients. They say it is important to find patients who may gain from tapering.

Why it is not certain yet

Several studies had a risk of bias. This was mainly from how outcomes were measured. It was also from open-label designs, where people knew their treatment. Follow-up times differed between studies. The abstract does not say who may gain from tapering. It does not give how many trials tested each drug.

Source

Efficacy of tapering biologics and JAK inhibitors in rheumatoid arthritis: A systematic review and meta-analysis.

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