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Comment on l’Ami et al titled ’Successful reduction of overexposure in patients with rheumatoid arthritis with high serum adalimumab concentrations: an open-label, non-inferiority, randomised clinical trial'
  1. Alfons A den Broeder1,
  2. Bart J F van den Bemt2
  1. 1Reumatologie, Sint Maartenskliniek, Nijmegen, Netherlands
  2. 2Pharmacy, Sint Maartenskliniek, Nijmegen, Netherlands
  1. Correspondence to Dr Alfons A den Broeder, Reumatologie, Sint Maartenskliniek, Nijmegen, 6522 JV, Netherlands; a.denbroeder{at}maartenskliniek.nl

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We have read the recent paper of l‘Ami et al titled ‘Successful reduction of overexposure in patients with rheumatoid arthritis with high serum adalimumab concentrations: an open-label, non-inferiority, randomised clinical trial’ with interest.1 The topic of dose tapering is an important one and we welcome all research efforts in this field, especially controlled trials. However, the design choices and interpretation of current study have some important limitations that in our opinion merit more attention.

First, l‘Ami et al set out to assess whether interval prolongation with 50% of adalimumab injections in patients with rheumatoid arthritis doing well is feasible when patients have a trough level …

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