Can Patients with Controlled Rheumatoid Arthritis Taper Methotrexate From Targeted Therapy and Sustain Remission? A Systematic Review and Meta-analysis

J Rheumatol. 2023;50(1):36–47 doi: 10.3899/jrheum.220152

This systematic review and meta-analysis of studies evaluated the proportion of patients in remission after the dosage of MTX was tapered, and concludes that patients with controlled RA may taper MTX from targeted therapy with a 10% reduction in the ability to sustain remission for up to 18 months.

Despite up to 30% of patients with RA being on a bDMARD monotherapy regime (partly due to MTX intolerance), and tapering DMARDs being a desirable goal for many patients with RA, the clinical benefits of tapering therapy remain unclear. To help add to the body of evidence in this area, Meng, et al. aimed to determine the risk of not being able to sustain remission after tapering MTX from targeted therapy in patients with controlled RA.