Table 3.
Summary of representative studies for discontinuation of biologic (infliximab) in RA patients where chemical DMARD was methotrexate
| Study | Country | Criteria | Observation time (years) | No. of discontinuations | Failed (%) or resumed | Effect of resuming biologic | References |
|---|---|---|---|---|---|---|---|
| TNF20 | UK | None (randomized) | 8 | 10 (1 died); 4/9 remission; ¼ drug free | 5/9; 56 | NS | [103] |
| RRR | Japan | DAS28 ≤ 3.2 at > 24 wk | 1 | 114 discontinued and 102 assessed at 1 year | 46/102; 45% | NS | [82] |
| BeSt | Netherlands | DAS28 ≤ 2.4 at 24 wk | 7.2 | 77/148 (52%) | 48% resumed; 17 months (median duration) | 84% DAS | [104] |
| BeSt | Netherlands | DAS28 ≤ 1.6 at ≥ 24 wk | 5 | 115/508 (23%) | 53/115 (46%) resumed; 23 months (median duration) | 39/53 (74%) DAS < 1.6 | [81] |
| BeSt | Netherlands | DAS28 ≤ 2.4 at ≥ 24 wk | 2 | 66/117 (56%) initially on biologic | NS | NS | [105] |
| BeSt | Netherlands | DAS28 ≤ 2.4 at ≥ 24 wk | 2 | 19/67 (29%); delayed infliximab 67/120 (56%) median duration 9.9 months | 10/67 (15%) resumed; median duration 3.7 months | NS | [106] |
BeSt, Behandel (treatment) strategies; DAS, Disease Activity Score, RRR, remission induction by Remicade in R.