The when and how of biologic agent withdrawal in rheumatoid arthritis: learning from large randomised controlled trials.

There has been great interest lately concerning the possibility that in the treatment of rheumatoid arthritis, biologic agents might be withdrawn for patients who achieve desirable targets, such as low disease activity or remission. While there are a number of reasons why such a treatment paradigm might be desirable, there is a paucity of relevant data at present to guide clinicians about embarking on such a treatment change. Data is starting to emerge, much of it from controlled trials, that can provide some guidance as to which patients might be the best candidates for such an approach. These data will provide answers to the key questions that remain concerning this important potential paradigm shift in the treatment of rheumatoid arthritis as well as other systemic inflammatory autoimmune diseases.