OBJECTIVE: To define the effects of withdrawing disease-modifying antirheumatic drug (DMARD) treatment from patients with established rheumatoid arthritis (RA) receiving stable, effective long-term DMARD treatment. METHODS: A systematic literature search was conducted. Studies were included that were of high quality and enrolled adults with RA over 2 years' duration. A meta-analysis was performed on the number of disease flares in groups withdrawn from DMARD treatment compared with those who continued to receive DMARD. RESULTS: The randomised controlled trial data were pooled into a meta-analysis and this showed that patients who withdrew from DMARD had a significantly worse risk of disease flare or deterioration than those who continued DMARD treatment. CONCLUSION: In patients who have their disease adequately controlled by DMARD and wish to reduce the dose or withdraw them, this should be done cautiously. Their disease activity should be monitored carefully so that they recommence DMARD therapy in the event of disease flare or deterioration.
OBJECTIVE: To define the effects of withdrawing disease-modifying antirheumatic drug (DMARD) treatment from patients with established rheumatoid arthritis (RA) receiving stable, effective long-term DMARD treatment. METHODS: A systematic literature search was conducted. Studies were included that were of high quality and enrolled adults with RA over 2 years' duration. A meta-analysis was performed on the number of disease flares in groups withdrawn from DMARD treatment compared with those who continued to receive DMARD. RESULTS: The randomised controlled trial data were pooled into a meta-analysis and this showed that patients who withdrew from DMARD had a significantly worse risk of disease flare or deterioration than those who continued DMARD treatment. CONCLUSION: In patients who have their disease adequately controlled by DMARD and wish to reduce the dose or withdraw them, this should be done cautiously. Their disease activity should be monitored carefully so that they recommence DMARD therapy in the event of disease flare or deterioration.
Authors: K Krüger; J Wollenhaupt; K Albrecht; R Alten; M Backhaus; C Baerwald; W Bolten; J Braun; H Burkhardt; G Burmester; M Gaubitz; A Gause; E Gromnica-Ihle; H Kellner; J Kuipers; A Krause; H-M Lorenz; B Manger; H Nüßlein; H-G Pott; A Rubbert-Roth; M Schneider; C Specker; H Schulze-Koops; H-P Tony; S Wassenberg; U Müller-Ladner Journal: Z Rheumatol Date: 2012-09 Impact factor: 1.372
Authors: Josef S Smolen; Robert Landewé; Ferdinand C Breedveld; Maxime Dougados; Paul Emery; Cecile Gaujoux-Viala; Simone Gorter; Rachel Knevel; Jackie Nam; Monika Schoels; Daniel Aletaha; Maya Buch; Laure Gossec; Tom Huizinga; Johannes W J W Bijlsma; Gerd Burmester; Bernard Combe; Maurizio Cutolo; Cem Gabay; Juan Gomez-Reino; Marios Kouloumas; Tore K Kvien; Emilio Martin-Mola; Iain McInnes; Karel Pavelka; Piet van Riel; Marieke Scholte; David L Scott; Tuulikki Sokka; Guido Valesini; Ronald van Vollenhoven; Kevin L Winthrop; John Wong; Angela Zink; Désirée van der Heijde Journal: Ann Rheum Dis Date: 2010-05-05 Impact factor: 19.103
Authors: Katinka Albrecht; Klaus Krüger; Jürgen Wollenhaupt; Rieke Alten; Marina Backhaus; Christoph Baerwald; Wolfgang Bolten; Jürgen Braun; Harald Burkhardt; Gerd R Burmester; Markus Gaubitz; Angela Gause; Erika Gromnica-Ihle; Herbert Kellner; Jens Kuipers; Andreas Krause; Hans-Martin Lorenz; Bernhard Manger; Hubert Nüßlein; Hans-Georg Pott; Andrea Rubbert-Roth; Matthias Schneider; Christof Specker; Hendrik Schulze-Koops; Hans-Peter Tony; Siegfried Wassenberg; Ulf Müller-Ladner Journal: Rheumatol Int Date: 2013-08-14 Impact factor: 2.631