Observational studyArthritis research & therapy2016
Tapering and discontinuation of TNF-α blockers without disease relapse using ultrasonography as a tool to identify patients with rheumatoid arthritis in clinical and histological remission.
Observational study in Arthritis research & therapy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
41 citing papers in PubMed, 2 syntheses or guidelines pooled it, 77 citations in OpenAlex.
- [S2e guideline: treatment of rheumatoid arthritis with disease-modifying drugs].Zeitschrift fur Rheumatologie · 2018Guideline
- Dosing down with biologic therapies: a systematic review and clinicians' perspective.Rheumatology (Oxford, England) · 2017Pooled it
- Prediction of flare following remission and treatment withdrawal in early rheumatoid arthritis: post hoc analysis of a phase IIIb trial with abatacept.Arthritis research & therapy · 2022Trial
- Adalimumab dose tapering in patients with rheumatoid arthritis who are in long-standing clinical remission: results of the phase IV PREDICTRA study.Annals of the rheumatic diseases · 2020Trial
- Optimizing treatment with tumour necrosis factor inhibitors in rheumatoid arthritis-a proof of principle and exploratory trial: is dose tapering practical in good responders?Rheumatology (Oxford, England) · 2017Trial
- Article
- EULAR-OMERACT consensus-based scoring system for synovitis 10 years later: a validated tool for routine care and clinical trials.RMD open · 2026Review
- Restricted cubic spline analysis of treatment duration before tocilizumab withdrawal and relapse risk in rheumatoid arthritis.Therapeutic advances in musculoskeletal disease · 2026Article
- Targeted phagocytosis of TNF-α by CAR macrophages restores immune homeostasis in arthritis.Theranostics · 2026Article
- The Role of Musculoskeletal Ultrasound in Biologic Drug Tapering and Relapse Monitoring: Findings from a One-Year Prospective Study in a Cohort of Rheumatoid Arthritis Patients in Sustained Clinical Remission.Diagnostics (Basel, Switzerland) · 2025Article
- Residual pain and fatigue are affected by disease perception in rheumatoid arthritis in sustained clinical and ultrasound remission.Clinical rheumatology · 2025Article
- Exploring perinatal mesenchymal stromal cells as a potential therapeutic strategy for rheumatoid arthritis.Heliyon · 2025Review
- Emodin promotes the recovery of rheumatoid arthritis by regulating the crosstalk between macrophage subsets and synovial fibroblast subsets.Animal models and experimental medicine · 2025Article
- Article
- Article
- Skeletal complications in patients with hemophilia: a single-center experience.Journal of orthopaedic surgery and research · 2023Article
- Prevalence and predictors of sustained remission/low disease activity after discontinuation of induction or maintenance treatment with tumor necrosis factor inhibitors in rheumatoid arthritis: a systematic and scoping review.Arthritis research & therapy · 2023Article
- From Bench to Bedside in Rheumatoid Arthritis from the "2022 GISEA International Symposium".Journal of clinical medicine · 2023Review
- Characteristics, polarization and targeted therapy of mononuclear macrophages in rheumatoid arthritis.American journal of translational research · 2023Review
- Synovial tissue macrophages in joint homeostasis, rheumatoid arthritis and disease remission.Nature reviews. Rheumatology · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn this study, we assessed whether clinical and ultrasonography (US)-based remission could be used to select patients with rheumatoid arthritis (RA) eligible to taper and discontinue anti-TNF-α therapy after achievement of remission, looking at disease relapse.
methodsForty-two patients with RA in sustained remission who were receiving anti-TNF-α treatment (Disease Activity Score <1.6 at three visits 3 months apart) underwent US evaluation of synovial hypertrophy (SH) and power Doppler (PD) signal presence. Five SH+/PD- patients with RA underwent US-guided knee synovial tissue biopsy to assess histological features of residual synovitis (CD68, CD3 and CD20 immunostaining) after sustained clinical remission was achieved. All patients were enrolled to taper first then discontinue anti-TNF-α. They were followed every 3 months afterwards, and the relapse rate was recorded.
resultsSelected SH+/PD- patients showed low-grade synovitis as demonstrated by the presence of CD68+ cells in the lining layer and few infiltrating CD3+ and CD20+ cells at the time sustained clinical remission was achieved. After anti-TNF-α tapering, 13 patients (30.9 %) relapsed and 29 (69.1 %) SH+/PD- patients maintained disease remission after 3 months and discontinued anti-TNF-α treatment. Among them, 26 patients (89.7 %) maintained disease remission status after 6 months of follow-up. All patients who relapsed were retreated with the previous biologic, following the last effective therapeutic regimen, again reaching a good European League Against Rheumatism response within 3 months.
conclusionsUS evaluation using PD signalling allows the identification of patients with RA in clinical and histological remission after tapering and discontinuing biologics.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.