TY - JOUR T1 - Tapering without relapse in rheumatoid arthritis patients with high TNF blocker concentrations: data from STRASS study JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis SP - e81 LP - e81 DO - 10.1136/annrheumdis-2019-215546 VL - 79 IS - 7 AU - Hubert Marotte AU - Mélanie Rinaudo-Gaujous AU - Cécile Petiet AU - Bruno Fautrel AU - Stéphane Paul Y1 - 2020/07/01 UR - http://ard.bmj.com/content/79/7/e81.abstract N2 - We read with interest the paper by l’Ami et al 1 reporting the safety of a single step-down strategy without flare-up of disease in rheumatoid arthritis (RA) patients treated with adalimumab associated with high trough concentrations. At the time of personalised medicine, prediction of the absence of relapse during tapering strategy is a huge challenge to improve this approach. Furthermore, EULAR recommendations proposed in RA patients in remission without glucocorticoids to first step down the bDMARDs.2 So, we investigated the interest of TNF blocker blood concentration assessment in order to predict the absence of relapse during tapering in the STRASS study.3 The STRASS study demonstrated the feasibility of step-down therapeutic strategy compared with maintenance strategy in RA patients in clinical remission treated with adalimumab or etanercept. In contrast to l’Ami study, which performed a single tapering, successive tapering step every 3 months in RA patient … ER -