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Down-titration and discontinuation strategies of tumour necrosis factor-blocking agents for rheumatoid arthritis in patients with low disease activity.
Cochrane Database Syst Rev
May 2019
Department of Rheumatology, Sint Maartenskliniek, Hengstdal 3, Nijmegen, Gelderland, Netherlands, 6574 NA.
Background: Anti-tumour necrosis factor (TNF) agents are effective in treating people with rheumatoid arthritis (RA), but are associated with (dose-dependent) adverse effects and high costs. To prevent overtreatment, several trials have assessed the effectiveness of down-titration compared with continuation of the standard dose. This is an update of a Cochrane Review published in 2014.
View Article and Find Full Text PDFBiological Dose Tapering in Daily Clinical Practice: A 10 Year Follow-up Study.
Reumatol Clin (Engl Ed)
July 2021
Servicio de Reumatología, Hospital Universitario Central de Asturias. Oviedo, Spain.
Objective: To describe practice patterns, long-term outcome, and related factors, in relation to biological therapies tapering in rheumatoid arthritis (RA) patients in a well-controlled real-world setting.
Methods: An observational longitudinal retrospective 10-year study was conducted in all RA patients receiving biological agents in an RA clinic from May 2003 to October 2013. Biological treatment of patients with sustained DAS28<3.
Dosing down and then discontinuing biologic therapy in rheumatoid arthritis: a review of the literature.
Int J Rheum Dis
February 2018
Medical and Regulatory Affairs, Pfizer, Inc., Makati City, Philippines.
Aim: To review the published studies that dose down and then discontinue biologic therapy in patients with rheumatoid arthritis (RA), particularly concerning the criteria for such dosing and the impact on clinical outcomes.
Methods: Published studies conducted in patients with RA that sequentially decreased the dose and then discontinued therapy were included if one or more of the following biologic disease modifying antirheumatic drugs (bDMARDs) was evaluated: abatacept, adalimumab, certolizumab, etanercept, golimumab, infliximab, rituximab or tocilizumab.
Results: Five studies qualified for inclusion.
Down-titration of biologics for the treatment of rheumatoid arthritis: a systematic literature review.
Rheumatol Int
November 2017
Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK.
Biologic therapies have improved the management of rheumatoid arthritis (RA) and the treat-to-target approach has resulted in many patients achieving remission. In the current treatment landscape, clinicians have begun considering dose reduction/tapering for their patients. Rheumatology guidelines in Asia, Europe, and the United States include down-titration of biologics but admit that the level of evidence is moderate.
View Article and Find Full Text PDFDose down-titration of biological DMARDs in patients with rheumatoid arthritis over time and in daily clinical practice.
Clin Exp Rheumatol
January 2017
Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IDISSC), Hospital Clínico San Carlos, Madrid, Spain.
Objectives: To describe and compare dosing optimisation in biological DMARDs (bDMARDs) and relapses after that, in a cohort of rheumatoid arthritis (RA) during clinical practice.
Methods: Observational retrospective longitudinal study of RA patients taking bDMARDs from December 1999 to November 2013. Optimisation was defined as a 15% decrease in dose either reducing single dose or separating dose interval administration, for at least 4 times the recommended period between dosages.
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