SynthesisRheumatology (Oxford, England)2017
Dosing down with biologic therapies: a systematic review and clinicians' perspective.
Synthesis in Rheumatology (Oxford, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 32 papers, 4 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
32 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Guideline
- Efficacy of withdrawal or tapering of bDMARDs vs. standard regimen in axial spondyloarthritis patients: systematic review and meta-analysis informing the update of the Spanish Society of Rheumatology Guideline.Frontiers in medicine · 2025Pooled it
- Pooled it
- Treatment Withdrawal Following Remission in Juvenile Idiopathic Arthritis: A Systematic Review of the Literature.Paediatric drugs · 2019Pooled it
- Coronavirus disease 2019, immune-mediated inflammatory diseases and immunosuppressive therapies - A Danish population-based cohort study.Journal of autoimmunity · 2021Trial
- Maintenance of clinical remission in early axial spondyloarthritis following certolizumab pegol dose reduction.Annals of the rheumatic diseases · 2020Trial
- Sustained discontinuation of infliximab with a raising-dose strategy after obtaining remission in patients with rheumatoid arthritis: the RRRR study, a randomised controlled trial.Annals of the rheumatic diseases · 2020Trial
- Analysis of relapse rates and risk factors of tapering or stopping pharmacologic therapies in axial spondyloarthritis patients with sustained remission.Clinical rheumatology · 2018Trial
- 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
- Feasibility of a 50% Dosing Interval Extension of Anti-IL-5 Biologics in Patients with Severe Asthma in Clinical Remission: A Real-World Validation Study.Journal of asthma and allergy · 2026Article
- Dose tapering and treatment de-escalation of biologic therapies in chronic rhinosinusitis with nasal polyps: a narrative review.Frontiers in surgery · 2026Review
- Disease activity-guided dose optimization including discontinuation of TNF inhibitors in rheumatoid arthritis is effective for up to 10 years: an observational follow-up of the DRESS study.Rheumatology (Oxford, England) · 2025Observational
- Anti-tumor necrosis factor (aTNF) weaning strategy in juvenile idiopathic arthritis (JIA): does duration matter?Clinical rheumatology · 2024Article
- Factors associated with discontinuation of biologics in patients with inflammatory arthritis in remission: data from the BIOBADASER registry.Arthritis research & therapy · 2023Observational
- Selection of treatment regimens based on shared decision-making in patients with rheumatoid arthritis on remission in the FREE-J study.Rheumatology (Oxford, England) · 2022Article
- Immune-mediated inflammatory disease therapeutics: past, present and future.Nature reviews. Immunology · 2021Review
- Dose tapering of biologic agents in patients with rheumatoid arthritis-results from a cohort study in Germany.Clinical rheumatology · 2021Article
- Dose Reduction of Tumor Necrosis Factor Inhibitor and its Effect on Medical Costs for Patients with Ankylosing Spondylitis.Rheumatology and therapy · 2021Article
- Induction of Sustained Clinical Remission in Early Axial Spondyloarthritis Following Certolizumab Pegol Treatment: 48-Week Outcomes from C-OPTIMISE.Rheumatology and therapy · 2020Article
- Does Abatacept Induce Testicular Toxicity?Archives of rheumatology · 2020Article
Corrections and comments
- Erratum issued
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The effectiveness of biologic therapies now means that remission or low disease activity are realistic targets for treatment. However, after achieving remission/low disease activity, the next steps remain unclear. The aim of this publication was to conduct a broad systematic literature review to evaluate dosing down of biologics. After screening papers and abstracts for relevance and application of inclusion/exclusion criteria, a structured extraction process was used to collect information on the included studies. Fifty-two papers were included in the analysis across rheumatic disease. In patients who discontinue therapy, remission is not typically sustained, with reported rates of relapse and flare across early RA (48-54%), established RA (2-84%), axial spondyloarthritis (11-53%) and PsA (44.9%). In many cases, an acceptable disease activity can be regained upon retreatment. More research is needed to understand the long-term impacts of these strategies on efficacy, safety and cost.
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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.