Australian recommendations on tapering of biologic and targeted synthetic disease-modifying anti-rheumatic drugs in inflammatory arthritis.
Journal
Internal medicine journal
ISSN: 1445-5994
Titre abrégé: Intern Med J
Pays: Australia
ID NLM: 101092952
Informations de publication
Date de publication:
10 2022
10 2022
Historique:
revised:
04
05
2022
received:
25
02
2022
accepted:
07
05
2022
pubmed:
15
5
2022
medline:
25
10
2022
entrez:
14
5
2022
Statut:
ppublish
Résumé
Biological and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARD) have been an important advance in the management of inflammatory arthritis, but are expensive medications, carry a risk of infection and other adverse effects, and are often perceived as a burden by patients. We used GRADE methodology to develop recommendations for dose reduction and discontinuation of b/tsDMARD in people with rheumatoid arthritis (RA), axial spondyloarthritis (AxSpA) and psoriatic arthritis (PsA) who have achieved a low disease activity state or remission. The recommendations form part of the Australian Living Guideline for the Pharmacological Management of Inflammatory Arthritis, an NHMRC-endorsed 'living' guideline, in which recommendations are updated in near real-time as new evidence emerges. Conditional recommendations were made in favour of dose reduction in RA and AxSpA but not in PsA. Abrupt discontinuation of b/tsDMARD is not recommended in any of the three diseases.
Substances chimiques
Biological Products
0
Antirheumatic Agents
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1799-1805Subventions
Organisme : Australian Commonwealth Government Value in Prescribing Program Grant: Biological Disease Modifying Anti-Rheumatic Drugs
ID : GO1512
Organisme : NHMRC Australia and New Zealand Musculoskeletal (ANZMUSC) Clinical Trials Network Centre of Research Excellence
ID : APP1134856
Informations de copyright
© 2022 Royal Australasian College of Physicians.
Références
Chan SJ, Stamp LK, Liebergreen N, Ndukwe H, Marra C, Treharne GJ. Tapering biologic therapy for rheumatoid arthritis: a qualitative study of patient perspectives. Patient 2020; 13: 225-34.
Hopkins AM, Proudman SM, Vitry AI, Sorich MJ, Cleland LG, Wiese MD. Ten years of publicly funded biological disease-modifying antirheumatic drugs in Australia. Med J Aust 2016; 204: 64-8.
Hazlewood GS, Loyola-Sanchez A, Bykerk V, Hull PM, Marshall D, Pham T et al. Patient and rheumatologist perspectives on tapering DMARDs in rheumatoid arthritis: a qualitative study. Rheumatology 2021; 61: 606-16.
Whittle S, Hill C, Buchbinder R. ARA member survey to identify priority questions for a living guideline for the pharmacological management of rheumatoid arthritis. Intern Med J 2020; 50: 39.
National Health and Medical Research Council (NHMRC). Guidelines for Guidelines Handbook. Canberra: NHMRC [cited 2022 Feb 7] 2016. Available from URL: www.nhmrc.gov.au/guidelinesforguidelines.
Akl EA, Meerpohl JJ, Elliott J, Kahale LA, Schünemann HJ. Living systematic review network. Living systematic reviews: 4. Living guideline recommendations. J Clin Epidemiol 2017; 91: 47-53.
Alonso-Coello P, Schünemann HJ, Moberg J, Brignardello-Petersen R, Akl EA, Davoli M et al. GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 1: introduction. BMJ 2016; 353: i2016.
GRADE Handbook. McMaster University; 2013 [cited 2022 Feb 7]. Available from URL: https://gdt.gradepro.org/app/handbook/handbook.html
Guyatt GH, Oxman AD, Kunz R, Falck-Ytter Y, Vist GE, Liberati A et al. Going from evidence to recommendations. BMJ 2008; 336: 1049-51.
Fautrel B, Pham T, Alfaiate T, Gandjbakhch F, Foltz V, Morel J et al. Step-down strategy of spacing TNF-blocker injections for established rheumatoid arthritis in remission: results of the multicentre non-inferiority randomised open-label controlled trial (STRASS: Spacing of TNF-blocker injections in Rheumatoid ArthritiS Study). Ann Rheum Dis 2016; 75: 59-67.
van Vollenhoven RF, Østergaard M, Leirisalo-Repo M, Uhlig T, Jansson M, Larsson E et al. Full dose, reduced dose or discontinuation of etanercept in rheumatoid arthritis. Ann Rheum Dis 2016; 75: 52-8.
Emery P, Bingham CO 3rd, Burmester GR, Bykerk VP, Furst DE, Mariette X et al. Certolizumab pegol in combination with dose-optimised methotrexate in DMARD-naïve patients with early, active rheumatoid arthritis with poor prognostic factors: 1-year results from C-EARLY, a randomised, double-blind, placebo-controlled phase III study. Ann Rheum Dis 2017; 76: 96-104.
Baker KF, Isaacs JD, Thompson B. “Living a normal life”: a qualitative study of patients’ views of medication withdrawal in rheumatoid arthritis. BMC Rheumatol 2019; 3: 2.
Hewlett S, Haig-Ferguson A, Rose-Parfitt E, Halls S, Freke S, Creamer P. Dose reduction of biologic therapy in inflammatory arthritis: a qualitative study of patients’ perceptions and needs. Musculoskeletal Care 2019; 17: 63-71.
Verhoef LM, van den Bemt BJF. Down-titration and discontinuation strategies of tumour necrosis factor-blocking agents for rheumatoid arthritis in patients with low disease activity. Cochrane Database Syst Rev 2019; 2019: CD010455.
Wailoo A, Hock ES, Stevenson M, Martyn-St James M, Rawdin A, Simpson E et al. The clinical effectiveness and cost-effectiveness of treat-to-target strategies in rheumatoid arthritis: a systematic review and cost-effectiveness analysis. Health Technol Assess 2017; 21: 1-258.
Tweehuysen L, van den Ende CH, Beeren FMM, Been EMJ, van den Hoogen FHJ, den Broeder AA. Little evidence for usefulness of biomarkers for predicting successful dose reduction or discontinuation of a biologic agent in rheumatoid arthritis: a systematic review. Arthritis Rheumatol 2017; 69: 301-8.
Schlager L, Loiskandl M, Aletaha D, Radner H. Predictors of successful discontinuation of biologic and targeted synthetic DMARDs in patients with rheumatoid arthritis in remission or low disease activity: a systematic literature review. Rheumatology 2020; 59: 324-34.
Smolen JS, Landewé RBM, Bijlsma JWJ, Burmester GR, Dougados M, Kerschbaumer A et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Ann Rheum Dis 2020; 79: 685-99.
Gossec L, Baraliakos X, Kerschbaumer A, de Wit M, McInnes I, Dougados M et al. EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update. Ann Rheum Dis 2020; 79: 700-12.
Ward MM, Deodhar A, Gensler LS, Dubreuil M, Yu D, Khan MA et al. 2019 Update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis. Arthritis Rheumatol 2019; 71: 1599-613.
Fraenkel L, Bathon JM, England BR, St Clair EW, Arayssi T, Carandang K et al. American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Care Res 2021; 2021: 924-39.
Singh JA, Guyatt G, Ogdie A, Gladman DD, Deal C, Deodhar A et al. Special Article: 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis. Arthritis Care Res 2019; 71: 2-29.
van der Heijde D, Ramiro S, Landewé R, Baraliakos X, Van den Bosch F, Sepriano A, et al. 2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis. Ann Rheum Dis. 2017: 978-91.