Background Withdrawal of boDMARDs is main concern of rheumatologists and many clinical trials were designed. However, in many reports, these observational periods were around 1 or 2 years, and long term analysis from clinical trial were few
Objectives To examine the long term biologics-free remission rate and its predictive factors in daily clinical practice.
Methods Retrospective observational study. 23 cases of patients who remained clinical remission (DAS28(CRP) <2.6) for 3 months or more discontinued their biologics and were observed for 5 years. Clinical findings and laboratory data at the withdrawal of boDMARDs were compared between relapse group and keeping remission group.
Results15 cases of relapse were observed. The rate of remaining remission was 80.0% at 1yr, 73.9% at 2yrs and 34.8% at 5yrs. Predictive factors were DAS28(CRP) and MMP-3 at the point of discontinuation of biologics (2.1±0.2 vs 1.7±0.1, 366.0±80.5 vs 155.2 vs 33.3). Cut-off value of DAS28(CRP) was 2.0 and MMP-3 was 190.2.
Conclusions Predictive factor which had already reported in several studies were valid in our long-term observational study. However, more strict remission standard was required for long-term bio-free remission. MMP-3 was also a promising predictive factor for long-term bio-free remission.
Disclosure of Interest None declared
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