Table 2 Patient, intervention and outcome characteristics of the studies
Patient characteristics | Intervention characteristics | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
S.No | Study | Criteria for TNFi withdrawal | Duration of RA during TNFi withdrawal, years | DAS28 during withdrawal | TNFi | DMARDs | Duration of dosage, months | Post-withdrawal follow-up time, months | DAS28 for/at Relapse | Events | Total Number | Event% |
1 | Quinn et al., 2005 [32] | – | 0.5 | – | I | M | 10.6 | 12 | – | 3 | 10 | 30 |
2 | Nawata et al., 2008 [33] | DAS28-ESR < 2.6 after 24 weeks of TNFi therapy | 2.4 | 6.6 | I | C; M | 6 to 12 | 14.2 | – | 5 | 9 | 55.55 (If follow-up is 12 months) |
3 | Brocq et al., 2009 [34] | DAS28 < 2.6 after TNFi therapy for 6 months | 11.3 | 5.54 | I, 5%; A, 25%; E, 75% | M, L | 40.25 | 12 | > 3.2 | 15 | 20 | 75 |
4 | Tanaka et al., 2010 [35] | DAS28 < 3.2 during > 24 weeks; Prednisolone therapy < 5 mg/day | 5.9 | 5.5 | I | M, P | – | 12 | > 3.2 | 46 | 102 | 45.1 |
5 | van den Broek et al., 2013 [36] | DAS44 < 2.4 for 6 months | 1.9 | 1.3 | I | – | 11 | 12 | > 2.4* | 50 | 108 | 48 |
6 | van der Maas et al., 2012 [37] | DAS28 > 2.6 after TNFi therapy for 6 months | 12 | – | I | M, CS | 67 | 12 | > 1.2 of baseline | 20 | 51 | 39 |
7 | Harigai et al., 2012 [38] | DAS28-CRP < 2.7 | 10.3 | 1.6 | A | M, CS | 45.8 | 12 | DAS28-CRP > 2.7 | 15 | 22 | 68.18 |
8 | Hirata et al., 2013 [39] | DAS28-ESR < 2.6 after 6 months | 7.1 | – | A | M | – | 6 | – | 21 | 50 | 42 |
9 | Smolen et al., 2013 [40] | DAS28 < 3.2 at 36 months of treatment | 6.9 | – | E | M | 36 | 12 | > 3.2 | 113 | 197 | 57.36 |
10 | Iwamoto et al., 2014 [41] | DAS28 < 2.6 | 8.2 | 1.9 (MEDIAN) | I | M, CS | – | 6 | > 3.2 | 16 | 40 | 40 (initial 42; 2 dropouts) |
11 | Kádár et al., 2014 [42] | Discontinuation for reasons including remission, low disease activity, or infections | 15 | 3.8 | Not mentioned specifically | – | 20 | 15 | – | 5 | 33 | 15.16 |
12 | Tanaka et al., 2015 [43] | DAS28-ESR < 2.6 for > 6 months, steroid free | 15 | 3.8 | A | M | 20 | 12 | DAS28-ESR > 2.6 | 27 | 52 | 51.92 |
13 | Moghadam et al., 2016 [44] | DAS28 < 3.2 during last 6 months; TNFi therapy ≥1 yr. | 12 | 1.98 | A, 51%; E, 40%; I, 5%; G, 3%; C, 1% | M, 82%; M + G, 4%; G, 1%; O, 7%; NONE, 6% | – | 12 | > 3.2 plus an increase of ≥0.6 over baseline | 272 | 531 | 51.2 |
14 | NCT00808509 (ADMIRE) | – | 10.4 | 1.98 | A | M | – | 12 | – | 13 | 15 | 87 |
15 | NCT00858780 (DOSERA) | – | – | – | E | M | – | 11 | – | 2 | 12 | 16.66 (Etanercept 50 mg) |
16 | NCT00858780 (DOSERA) b | – | – | – | E | M | – | 11 | – | 1 | 12 | 8.33 (Etanercept 25 mg) |