The practicability of  bDMARDs dose reduction/ tapering in daily practice has been determined  in this study. The dMARDs more appropriate for dose reduction and cost savings have also been assessed.

The records of 332 eligible RA patients from Brussels UCLouvain cohort were retrospectively analysed. Out of these patients, 140 patients were given a tapered dose, and 192 were given constant doses of bDMARDs. 

The age of patient at diagnosis (43.1 versus 38.7 years), health assessment questionnaire (HAQ) score (1.3 versus 1.5), RF positivity rate (83.3 versus 72.9%) and extent of disease at the time of bDMARD initiation (9.7 versus 12.1 years) were notably different between the groups.

Remarkably, more patients receiving a tapered dose were treated with bDMARDs plus methotrexate (MTX) (86.7% versus 73.8%). Anti-TNF agents were found to be most frequently prescribed medications. During follow-up, only 15 patients had a flare. The tapered-dose group had adalimumab (ADA), etanercept (ETA) and rituximab (bDMARDs) which were linked with the most significant declines in annual cost.

In routine clinical practice, tapering bDMARDs in RA patients who have attained low disease activity or remission is possible many patients, thus decreasing potential adverse effects and yearly drug expenditure.