How can we approach tapering or discontinuing biologic DMARDs in patient in their 80s with well controlled rheumatoid arthritis?

Not a simple answer, unfortunately, as we know Rheumatoid arthritis (RA) is a chronic disease and thus requires long-term treatment!

If, however, the patient's preference is to taper or discontinue a biologic DMARD, per ACR RA treatment guidelines, it can be considered after the patient has been in r...

I go nice and slow to take the elderly off DMARD: I generally try to encourage this during the spring, summer, and fall months to remove the dreaded OA/DJD that acts up in winter. If MTX wean from 8 to 6, check ESR/CRP hang in three months. Then 6 to 4 and check ESR/CRP and hang again. Then off and ...

I agree that this is a nuanced and highly individualized decision. While the ACR guidelines (2021) allow consideration of tapering after at least 6 months of sustained remission, they also conditionally recommend continuing at least one DMARD rather than complete withdrawal, because of the well-docu...