Whittle, S.L.Glennon, V.Johnston, R.V.Avery, J.C.Bell, J.S.Brennan, S.E.Fong, C.Hissaria, P.Horgan, B.O'Neill, S.Pisaniello, H.L.Trevena, L.Whittaker, G.A.Wluka, A.Buchbinder, R.2022-10-262022-10-262022Internal Medicine Journal, 2022; 52(10):1799-18051444-09031445-5994https://hdl.handle.net/2440/136742Biological 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.en© 2022 Royal Australasian College of Physicians.HumansArthritis, PsoriaticArthritis, RheumatoidAntirheumatic AgentsBiological ProductsAustraliaJournal article10.1111/imj.158162022-10-26612997Whittle, S.L. [0000-0001-7417-7691]Avery, J.C. [0000-0002-8857-9162]Pisaniello, H.L. [0000-0002-0425-1697]