Background The feasibility of down-titration or discontinuation of biological drugs has been demonstrated by several studies. However, there are limited data about the prevalence of successful down-titration in daily clinical practice.
Objectives To Evaluate the prevalence of down-titration or discontinuation of infliximab (Ifx), adalimumab (Ada) and etanercept (Eta) in RA patients with low disease activity or remission and the effects on disease activity.
Methods From January 2000 to December 2012, all RA patients who started treatment with Ifx, Ada and Eta as the first biologic drug, were included in the study. Patients who had stable low disease activity or remission for at least 6 months are treated according to our local protocol increasing the interval between doses. Prevalence of down-titration and discontinuation were described. Disease activity was assessed using disease activity score 28 (DAS28) and functional capacity was measured through the Health Assessment Questionnaire (HAQ).
Results Of the 276 patients, 124 were treated with Ifx, 85 with Ada and 67 with Eta. The proportion of patients who were seropositive, the mean DAS28, mean HAQ and mean erythrocyte sedimentation rate (ESR) were different between groups. Baseline characteristics are depicted in the table bellow.
Conclusions In our cohort down-titration of Ifx, Ada and Eta is possible in an important proportion of RA patients without a relevant change in clinical and functional outcomes. The proportion of Ifx-treated patients who could be down-titrated was significantly lower than in patients treated with Ada and Etn.
Disclosure of Interest None Declared