Rheumatoid arthritis (RA) is the most common inflammatory joint disorder. Since twenty year and the use of synthetic disease-modifying anti-rheumatic drugs (csDMARDs) and biological (b)DMARD, remission can be reached. When remission is obtained, the physician has no recommendations for managing a step-down, and future guidelines will be useful to assist the clinician. Recent data suggest that tapering is feasible, but with high risk of flares. Flares are less frequent when bDMARD blood concentration is high. But, the optimal adalimumab concentration to keep before a step of tapering no targeting personal is unknown.
Patient over 18 years of age
Patients with a diagnosis of RA according to ACR/EULAR 2010 criteria
Remission according to DAS28<=2.6 for at least 6 months
ADA 40 mg every two weeks (= every 14 days) according to the standard regimen
Incapacity or refusal to understand and / or sign informed consent to participate in the study.
Existing pregnancy, lactation, or intended pregnancy within the next 15 months
Fibromyalgia associated to RA
Any dose of prednisone for RA treatment 6 months before inclusion
Centre Hospitalier Universitaire de Saint Etienne
Lead sponsor
AAP MESSIDOR
Collaborator