Rheumatoid Arthritis — SCE Rheumatology MCQ

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ModerateRheumatoid ArthritisRheumatoid ArthritisSCE Rheumatology

A 39-year-old woman with RA achieves remission on Methotrexate 15 mg weekly plus Sulfasalazine. She has been in sustained remission (DAS28 <2.6) for over 12 months. She asks about reducing treatment. According to EULAR 2022, what is the recommended approach?

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Correct answer: C — Taper Sulfasalazine first while maintaining Methotrexate

EULAR 2022 recommends that in patients achieving sustained remission on combination csDMARDs, cautious tapering of csDMARDs can be considered. The anchor DMARD (Methotrexate) should be maintained while the additional agent is tapered first. Complete withdrawal of all DMARDs is associated with high relapse rates and is generally not recommended. Methotrexate should be the last drug reduced, if at all, given its role as the cornerstone of RA treatment.

Reference: EULAR 2022 - Recommendations for management of RA with synthetic and biological DMARDs