SynthesisArthritis & rheumatology (Hoboken, N.J.)2017
Little Evidence for Usefulness of Biomarkers for Predicting Successful Dose Reduction or Discontinuation of a Biologic Agent in Rheumatoid Arthritis: A Systematic Review.
Synthesis in Arthritis & rheumatology (Hoboken, N.J.), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 5 of them syntheses that pooled it.
What it found
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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.
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Who cites it
31 citing papers in PubMed, 5 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- What are the benefits of therapeutic drug monitoring in the optimization of adalimumab therapy? a systematic review and meta-analysis up to 2022.Frontiers in pharmacology · 2024Pooled it
- Pooled it
- Reduction of biologics in rheumatoid arthritis: a systematic review and meta-analysis.Rheumatology international · 2020Pooled it
- Treatment Withdrawal Following Remission in Juvenile Idiopathic Arthritis: A Systematic Review of the Literature.Paediatric drugs · 2019Pooled it
- Down-titration and discontinuation strategies of tumour necrosis factor-blocking agents for rheumatoid arthritis in patients with low disease activity.The Cochrane database of systematic reviews · 2019Pooled it
- Proteomic Approaches to Defining Remission and the Risk of Relapse in Rheumatoid Arthritis.Frontiers in immunology · 2021Trial
- Article
- Bridging the gap: combining treat-to-target and difficult-to-treat strategies in the management of rheumatoid arthritis.Nature reviews. Rheumatology · 2026Review
- Biomarkers of treatment response in rheumatoid arthritis: from conventional markers to tissue immunophenotype.Frontiers in immunology · 2026Review
- Article
- Managing Disease-Modifying Antirheumatic Drugs (DMARDs) for Patients Undergoing Elective Spine Surgery: A Pilot Survey.Spine surgery and related research · 2024Article
- 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
- Tailored therapeutic decision of rheumatoid arthritis using proteomic strategies: how to start and when to stop?Clinical proteomics · 2023Review
- Factors associated with discontinuation of biologics in patients with inflammatory arthritis in remission: data from the BIOBADASER registry.Arthritis research & therapy · 2023Observational
- Discontinuation of biologic DMARDs in non-systemic JIA patients: a scoping review of relapse rates and associated factors.Pediatric rheumatology online journal · 2022Article
- Tumour necrosis factor inhibitor dose adaptation in psoriatic arthritis and axial spondyloarthritis (TAPAS): a retrospective cohort study.Rheumatology (Oxford, England) · 2022Article
- Using real-world data to dynamically predict flares during tapering of biological DMARDs in rheumatoid arthritis: development, validation, and potential impact of prediction-aided decisions.Arthritis research & therapy · 2022Article
- [Innovative strategies for treatment of rheumatoid arthritis].Zeitschrift fur Rheumatologie · 2022Review
- Prediction of disease flare by biomarkers after discontinuing biologics in patients with rheumatoid arthritis achieving stringent remission.Scientific reports · 2021Article
- Spacing the Administration Interval of Anti-TNF Agents: A Valid Strategy for Patients with Inflammatory Bowel Disease?Digestive diseases and sciences · 2020Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo systematically review studies addressing prediction of successful dose reduction or discontinuation of a biologic agent in rheumatoid arthritis (RA).
methodsPubMed, Embase, and Cochrane Library databases were searched for studies that examined the predictive value of biomarkers for successful dose reduction or discontinuation of a biologic agent in RA. Two reviewers independently selected studies, and extracted data and assessed the risk of bias. A biomarker was classified as a "potential predictor" if the univariate association was either strong (odds ratio or hazard ratio >2.0 or <0.5) or statistically significant. For biomarkers that were studied multiple times, qualitative best-evidence synthesis was performed separately for the prediction of successful dose reduction and discontinuation. Biomarkers that were defined in ≥75% of the studies as potential predictors were regarded as "predictor" for the purposes of our study.
resultsOf 3,029 nonduplicate articles initially searched, 16 articles regarding 15 cohorts were included in the present study. Overall, 17 biomarkers were studied multiple times for the prediction of successful dose reduction, and 33 for the prediction of successful discontinuation of a biologic agent. Three predictors were identified: higher adalimumab trough level for successful dose reduction and lower Sharp/van der Heijde erosion score and shorter symptom duration at the start of a biologic agent for successful discontinuation.
conclusionThe predictive value of a wide variety of biomarkers for successful dose reduction or discontinuation of biologic treatment in RA has been investigated. We identified only 3 biomarkers as predictors, in just 2 studies. The strength of the evidence is limited by the low quality of the included studies and the likelihood of reporting bias and multiple testing.
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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.