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How do you counsel patients who prefer to continue TNFi therapy indefinitely for rheumatoid arthritis despite long-standing remission?

Do you advocate to taper the TNF-i or simply continue to monitor for long term adverse events? This question is part of a collaboration with RheumMadness and is specifically in reference to: Tapered TNFi
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In patients with RA in long standing remission (at least 2 years), do you attempt TNF withdrawal?

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3 Answers
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Rheumatology · Berkshire Health Systems
Answered on

I explain the risk of stopping and having a return of disease after stopping (that this could be a “drug holiday” of limited duration) and that this return of disease activity may not respond to restarting the TNF blockade therapy that had been working well for them. Then they would have to start a ...

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Rheumatology · Texas Tech University Health Sciences Center
Answered on

I wouldn't stop it especially if RF is still positive.

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Mednet MemberInvited Expert
Rheumatology · Mobile Medical Care Inc
Answered on

I agree with the cautious response outlined by Drs. @Dr. First Last & @Dr. First Last in the risk of a challenged RA flare with the withdrawal of iTNF therapy; I tend to for Boolean criteria-1 before having the discussion. I personally like to perform ultrasound on these patients, using Dr Naredo’s ...

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