Tapering and discontinuation of @entity1499 in @entity1 with XXXX treated with TNF inhibitors: data from the DREAM registry.

@entity1 @entity5 @entity6822 @entity1499 @entity309
OBJECTIVES: To study the number of @entity1 that taper or discontinue concomitant @entity1499 ( @entity6822 ) in daily practice in @entity1 with @entity309 ( @entity309 ) treated with @entity5 necrosis factor inhibitor (TNFi) and to analyse the effects of that adaption on disease activity and drug survival. METHODS: Data were collected from the Dutch @entity309 Monitoring (DREAM) registry. @entity1 who started their first TNFi were included in the study. Treatment effectiveness after @entity6822 tapering or discontinuation was analysed using Disease Activity Score of 28 joints (DAS28). Drug survival of the TNFi was analysed using the Cox proportional hazard model with a time-dependent covariate. RESULTS: In 458 @entity1 (34%), @entity6822 was tapered, 126 @entity1 (10%) discontinued @entity6822 and 747 @entity1 (56%) continued @entity6822 at the same dose. On average, DAS28 improved after tapering @entity6822 (-0.40, -0.45) and after stopping @entity6822 (-0.28, -0.12) at 6 and 12   months. In the taper group, 21% of the @entity1 relapsed (DAS28 increase >0.6), and in the discontinuation group this was 21% and 24% at 6 and 12   months, respectively. @entity1 who taper and discontinue @entity6822 have a similar DAS28 score over time as @entity1 who continue @entity6822 . Moreover, there was no influence of tapering or discontinuation of @entity6822 on long-term drug survival of TNFi. CONCLUSIONS: In daily practice, tapering or discontinuation of concomitant @entity6822 in @entity1 with @entity309 treated with TNFi frequently occurs and it does not seem to influence the average DAS28 over time or the long-term TNFi drug survival. It appears that in daily clinical practice the correct @entity1 are selected to taper or discontinue @entity6822 .
