杉谷　直大    Department   Other, Other    Position
Article types	Original article
Language	English
Peer review	Non peer reviewed
Title	Successful discontinuation of biological disease-modifying antirheumatic drugs in patients with rheumatoid arthritis in real-world settings.
Journal	Formal name：Modern rheumatology Abbreviation：Mod Rheumatol ISSN code：14397609/14397595
Volume, Issue, Page	31(4),pp.790-795
Author and coauthor	Ochiai Moeko, Tanaka Eiichi, Sato Eri, Inoue Eisuke, Abe Mai, Saka Kumiko, Sugano Eri, Sugitani Naohiro, Higuchi Yoko, Yamaguchi Rei, Sugimoto Naoki, Ikari Katsunori, Nakajima Ayako, Yamanaka Hisashi, Harigai Masayoshi
Publication date	2021/07
Summary	OBJECTIVES:To analyze the proportion of successful biological disease-modifying antirheumatic drugs (bDMARDs) discontinuation and related factors in patients with rheumatoid arthritis (RA) in clinical settings.METHODS:Among 1775 RA patients who started bDMARDs between 2003 and 2012, 43 patients with DAS28-ESR <3.2 at the time of bDMARD discontinuation were extracted. Patients were divided into two groups (bio-free success: BS and bio-free failure: BF groups) based on bDMARD usage and disease activity 1 year after discontinuation. We evaluated the proportion of bio-free success and assessed factors related to bio-free success.RESULTS:Twenty-five patients (58.1%: BS group) maintained discontinuation of bDMARDs and DAS28-ESR <3.2 at 1 year after discontinuation. The median DAS28-ESR at bDMARD initiation was lower in the BS group than in the BF group (3.95 vs 5.04; p = .04). The BS group experienced a larger decrease in average glucocorticoid (GC) dose during bDMARD use than the BF group (-3.0 mg/day vs 0 mg/day; p = .01).CONCLUSION:bDMARDs were discontinued without flare up of RA in 58.1% of patients with RA in clinical settings. A lower DAS28-ESR at initiation and reduction of GC dose before discontinuation of bDMARD were important factors associated with bio-free success.
DOI	10.1080/14397595.2021.1883252
PMID	33538611