RESEARCH - Withdrawal of DMARDs in patients with RA

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Ann Rheum Dis. 2009 Feb 17.

Withdrawal of DMARDs in patients with Rheumatoid Arthritis: a

systematic review and meta-analysis.

O'Mahony R, s A, Deighton C, D.

National Collaborating Centre for Chronic Conditions, Royal College of

Physicians, United Kingdom.

OBJECTIVE: To define the effects of withdrawing DMARD treatment from

patients with established RA receiving stable, effective long-term

DMARD treatment.

METHODS: A systematic literature search was conducted. Studies were

included that were of high quality and enrolled adults with RA over 2

years duration. A meta-analysis was performed on the number of disease

flares in groups withdrawn from DMARD treatment compared to those who

continued to receive DMARDs.

RESULTS: The RCT data were pooled into a meta-analysis and this showed

that patients who withdrew from DMARDs had a significantly worse risk

of disease flare or deterioration than those who continued DMARD

treatment.

CONCLUSION: We recommend that in patients who have their disease

adequately controlled by DMARDs and wish to reduce the dose or

withdraw them, this should be done cautiously. Their disease activity

should be monitored carefully so that they recommence DMARD therapy in

the event of disease flare or deterioration.

PMID: 19224904

http://www.ncbi.nlm.nih.gov/pubmed/19224904

Not an MD