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Dosing down with biologic therapies: a systematic review and clinicians' perspective.
- Source :
- Rheumatology; Nov2017, Vol. 56 Issue 11, p1847-1856, 10p, 1 Diagram, 3 Charts
- Publication Year :
- 2017
-
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. [ABSTRACT FROM AUTHOR]
- Subjects :
- ANKYLOSING spondylitis
ANTIRHEUMATIC agents
BIOTHERAPY
INFORMATION storage & retrieval systems
MEDICAL databases
MEDICAL information storage & retrieval systems
MEDLINE
ONLINE information services
PSORIATIC arthritis
RHEUMATOID arthritis
SYSTEMATIC reviews
EVIDENCE-based medicine
DISEASE relapse
TERMINATION of treatment
DISEASE remission
Subjects
Details
- Language :
- English
- ISSN :
- 14620324
- Volume :
- 56
- Issue :
- 11
- Database :
- Complementary Index
- Journal :
- Rheumatology
- Publication Type :
- Academic Journal
- Accession number :
- 125907255
- Full Text :
- https://doi.org/10.1093/rheumatology/kew464