Introduction
rheumatoid arthritis, RA
RHEUMATOID ARTHRITIS, DRUG WITHDRAWAL, ADVERSE EVENTS, DISEASE, REMISSION
With the development and launch of the Janus kinase (JAK) inhibitor, tofacitinib, treatment options for rheumatoid arthritis (RA) have expanded, which has enabled more patients to achieve clinical remission.Achieving clinical remission in patients with RA is the primary goal and using disease-modifying antirheumatic drug (DMARDs) is essential.There are two major benefits to consider when deciding whether or not to withdraw tsDMARDs. One is from the perspective of adverse events as mentioned above: drug withdrawal can eliminate the risk of tsDMARD-related adverse events. The other is reducing medical costs. Since the costs of tsDMARDs are expensive, their withdrawal can mitigate the financial burden on patients as well as on society. Considering these factors, withdrawal of tsDMARDs is reasonable as an option for patients in sustained remission.We have previously reported the impact on disease activity after withdrawal of tofacitinib in patients who completed phase III and long-term extension study of tofacitinib.