• treatment discontinuation
• anti-tumour necrosis factor α
• rheumatoid arthritis

Treatment with biological agents is currently inducing dramatic changes in the treatment of the most common inflammatory rheumatic diseases: rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis. Several recent papers have established the efficacy of mainly three different agents directed against tumour necrosis factor α (TNFα)—infliximab, etanercept, and adalimumab—in these rheumatic diseases.^1–6 Because these treatments may have rare but severe side effects⁷ and because they are expensive, guidelines and recommendations have been proposed by expert groups, especially for RA⁸ and recently also for AS.⁹

In the AS consensus paper, which was produced by the ASAS working group, recommendations for the discontinuation of anti-TNF therapy in clinical practice have been included.

This is in contrast with the RA guidelines, which in St Martin were discussed and updated only recently in April 2003. Although guidelines for the discontinuation of treatment in RA were proposed in the discussions held there, this issue has not been put forward mainly as a result of the argument that this subject is too difficult to deal with. Thus, the arguments and proposals published in this letter may represent a minority statement (in relation to the group that met to …