Table 1 Overview of tapering studies
From: Tapering of biological treatment in autoinflammatory diseases: a scoping review
Author | Study design | Disease | Gender (%, female) | Biological treatment, add-on medication | Criteria for inactive disease/remission | Criteria for start of tapering/discont. | Reported strategy of treatment tapering/discont. | Patients started tapering/discont. (n) | Patients with successful tapering (n) | Patients with successful discont. (n) | Follow- up time |
|---|---|---|---|---|---|---|---|---|---|---|---|
Vastert et al. [19] | Prospective cohort study | sJIA | 35% | Anakinra 2 mg/kg daily, max. 100 mg daily, no cDMARDs | Wallace criteria or Adapted ACR Pedi 90 response | Inactive disease or adapted ACR Pedi 90 responses at 3 months | Alternate-day regimen for 1 month, followed by discont., 2nd tapering attempt 3–6 months later | 15 | 7 (first attempt), plus additional 4 (second attempt) | 11 | at least 12 months, mean follow-up 2.67 years (1-4.5 years) |
Ter Haar et al. [18] | Prospective cohort study | sJIA | 40% | Anakinra 2 mg/kg daily (max. 100 mg daily) (incomplete response: 4 mg/kg daily; max 200 mg daily), no cDMARDS | Wallace criteria | Inactive disease at 3 months | Alternate-day regimen for 1 month, followed by discont., | 33 | 31 | 18 | Up to 5 years |
Quartier et al. [17] | IIIb/IV Open-label RCT | sJIA | 52% | Canakinumab 4 mg/kg q4w, no cDMARDs | Wallace criteria | Inactive disease for 6 months | Arm 1: dose reduction three steps approach (each 24 weeks): 4 mg/kg/q4w to 2 mg/kg/q4w to 1 mg/kg/q4w to discontinuation Arm 2: interval prolongation three steps approach (each 24 weeks): 4 mg/kg/q4w to 4 mg/kg/q8w to 4 mg/kg/q12w to discontinuation | Arm 1 38 Arm 2 37 | Arm 1 27/26/17* Arm 2 31/30/8* *step 1/2/3 | Arm 1 17 Arm 2 8 | 24 weeks |
Kostik et al. [16] | Retro-spective obser-vational study | sJIA | 57% | Tocilizumab 12 mg/kg (< 30 kg) or 8 mg/kg (≥ 30 kg) q2w or q4w, add-on cDMARDs | Wallace criteria | Inactive disease for ≥ 12 months | Interval prolongation up to q5w for 3–4 months, then q6w for 3 months, if no clinical and laboratory signs of disease activity treatment was discontinued | 7 | 7 (of these 3 with MTX) | 7 (of these 3 with MTX) | No MTX: 1078 days (IQR 848–1217), MTX: 918 days (IQR 508–1078) |