The leading reasons for non-adherence to treatment were economic (35.6%) and good response (31.4%); for dosage reduction were responsive (62%) and economical (24.6%); for bDMARD discontinuation were due to the effects of the Covid-19 pandemic (40.6%), drug shortage (21.7%) and economy (20.3%); and for drug switching were non-response (30.3%), drug shortage (36.4%), and economical (27.3%).