Dose reduction and discontinuation of b/tsDMARDs
Australia & New Zealand Musculoskeletal Clinical Trials Network (ANZMUSC), 2023
Dose reduction and discontinuation of b/tsDMARDs should only be initiated by a specialist following discussion with the patient. Stepwise dose reduction may be considered for people with RA who have been in sustained clinical remission or low disease activity for at least 6 months. The b/ts DMARD may even be ceased providing the treatment target (clinical remission) is maintained. Abrupt cessation of b/tsDMARDs without prior dose reduction is not recommended.
Advice about dose reduction and discontinuation of b/tsDMARDs in RA is available from An Australian Living Guideline for the Pharmacological Management of Inflammatory Arthritis: Rheumatoid Arthritis: Dose reduction or discontinuation of biologic or targeted synthetic DMARDs1.