Australian recommendations on tapering of biologic and targeted synthetic disease-modifying anti-rheumatic drugs in inflammatory arthritis

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dc.contributor.authorWhittle, S.L.
dc.contributor.authorGlennon, V.
dc.contributor.authorJohnston, R.V.
dc.contributor.authorAvery, J.C.
dc.contributor.authorBell, J.S.
dc.contributor.authorBrennan, S.E.
dc.contributor.authorFong, C.
dc.contributor.authorHissaria, P.
dc.contributor.authorHorgan, B.
dc.contributor.authorO'Neill, S.
dc.contributor.authorPisaniello, H.L.
dc.contributor.authorTrevena, L.
dc.contributor.authorWhittaker, G.A.
dc.contributor.authorWluka, A.
dc.contributor.authorBuchbinder, R.
dc.date.issued2022
dc.description.abstractBiological and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) have been an important advance in the management of inflammatory arthritis, but are expensive medications, carry a risk of infection and other adverse effects, and are often perceived as a burden by patients. We used GRADE methodology to develop recommendations for dose reduction and discontinuation of b/tsDMARDs in people with rheumatoid arthritis (RA), axial spondyloarthritis (AxSpA) and psoriatic arthritis (PsA) who have achieved a low disease activity state or remission. The recommendations form part of the Australian Living Guideline for the Pharmacological Management of Inflammatory Arthritis, an NHMRC-endorsed 'living' guideline, in which recommendations are updated in near real-time as new evidence emerges. Conditional recommendations were made in favour of dose reduction in RA and AxSpA but not in PsA. Abrupt discontinuation of b/tsDMARDs is not recommended in any of the three diseases.
dc.description.statementofresponsibilitySamuel L. Whittle, Vanessa Glennon, Renea V. Johnston, Jodie C. Avery, J. Simon Bell, Sue E. Brennan, Christopher Fong, Pravin Hissaria, Ben Horgan, Sean O, Neill, Huai Leng Pisaniello, Lyndal Trevena, Glen A. Whittaker, Anita Wluka, and Rachelle Buchbinder
dc.identifier.citationInternal Medicine Journal, 2022; 52(10):1799-1805
dc.identifier.doi10.1111/imj.15816
dc.identifier.issn1444-0903
dc.identifier.issn1445-5994
dc.identifier.orcidWhittle, S.L. [0000-0001-7417-7691]
dc.identifier.orcidAvery, J.C. [0000-0002-8857-9162]
dc.identifier.orcidPisaniello, H.L. [0000-0002-0425-1697]
dc.identifier.urihttps://hdl.handle.net/2440/136742
dc.language.isoen
dc.publisherWiley
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1134856
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1194483
dc.rights© 2022 Royal Australasian College of Physicians.
dc.source.urihttps://doi.org/10.1111/imj.15816
dc.subjectHumans
dc.subjectArthritis, Psoriatic
dc.subjectArthritis, Rheumatoid
dc.subjectAntirheumatic Agents
dc.subjectBiological Products
dc.subjectAustralia
dc.titleAustralian recommendations on tapering of biologic and targeted synthetic disease-modifying anti-rheumatic drugs in inflammatory arthritis
dc.typeJournal article
pubs.publication-statusPublished

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