{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T06:07:48Z","timestamp":1771135668086,"version":"3.50.1"},"reference-count":48,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T00:00:00Z","timestamp":1765065600000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We aim to review the current state of evidence about tapering or withdrawal of biological (b\u2010) or targeted synthetic (ts\u2010) disease\u2010modifying anti\u2010rheumatic drugs (DMARDs) in psoriatic arthritis (PsA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We search the literature for published articles in withdrawal or tapering of b\u2010\/ts\u2010DMARDs in PsA. We summarized data according to remission criteria prior to therapy tapering, relapse criteria, relapse rate and re\u2010treatment effects. We collected data on the effect of tapering on safety, quality of life, costs, and predictors for successful tapering.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 11 observational studies and 4 randomized controlled trials (RCT) in tapering or withdrawal of b\u2010DMARDs were included. Most data were derived from observational studies; high quality of evidence from RCTs remained sparse. b\u2010DMARDs withdrawal generally led to high rates of flare, whilst gradual tapering of therapy while maintaining a low disease activity state may be feasible, and safe. There were high rates of response with re\u2010treatment with b\u2010DMARDs regimens during flares. Heterogeneity in remission criteria prior to therapy tapering regimens and relapse criteria was noted. Lower disease activity prior to tapering seems to predict success more consistently; other predictive variables were inconsistent. Predictive biomarkers for successful therapy tapering were lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Tapering of biologic therapy in PsA patients may be effective and safe in low disease activity states. Lack of standardization of tapering strategies warrants further studies. The knowledge gap lies in the lack of data from high\u2010quality RCTs and biomarkers that predict success in tapering therapy for patients with PsA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1756-185x.70498","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T06:59:46Z","timestamp":1765177186000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Discontinuing or Tapering Biologic or Targeted Synthetic Disease\u2010Modifying Anti\u2010Rheumatic Drugs in Psoriatic Arthritis: A Systematic Literature Review"],"prefix":"10.1111","volume":"28","author":[{"given":"Natalie Min Yi","family":"Aw","sequence":"first","affiliation":[{"name":"Department of Rheumatology &amp; Immunology, Singapore General Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Warren","family":"Fong","sequence":"additional","affiliation":[{"name":"Department of Rheumatology &amp; Immunology, Singapore General Hospital  Singapore"},{"name":"Duke\u2010NUS Medical School  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6749-7598","authenticated-orcid":false,"given":"Kichul","family":"Shin","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine, College of Medicine Seoul National University  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stanley","family":"Angkodjojo","sequence":"additional","affiliation":[{"name":"Sengkang General Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8492-6342","authenticated-orcid":false,"given":"Ying Ying","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Rheumatology &amp; Immunology, Singapore General Hospital  Singapore"},{"name":"Duke\u2010NUS Medical School  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,7]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-021-00293-y"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-022-00776-6"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.220315"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm.3260"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-211734"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-022-00798-0"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40273-018-0618-5"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61704-9"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-016-3452-1"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41927-019-0070-y"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kew464"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kew033"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kew033"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204229"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2016-000395"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.102053"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar1740"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780380107"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/039463201302600333"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.161567"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1155\/2023\/5655687"},{"key":"e_1_2_11_24_1","first-page":"201","article-title":"Sustained Maintenance of Clinical Remission After Adalimumab Dose Reduction in Patients With Early Psoriatic Arthritis: A Long\u2010Term Follow\u2010Up Study","volume":"6","author":"Cantini F.","year":"2012","journal-title":"Biologics"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-021-05728-1"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kew269"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22529"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/0394632015599446"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keab741"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.41716"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1080\/03009742.2022.2028364"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1080\/03009742.2023.2164979"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2022-222260"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2022.109256"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.4078\/jrd.2021.28.4.176"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1080\/14712598.2022.2152321"},{"issue":"5","key":"e_1_2_11_37_1","first-page":"CD010455","article-title":"Down\u2010Titration and Discontinuation Strategies of Tumour Necrosis Factor\u2010Blocking Agents for Rheumatoid Arthritis in Patients With Low Disease Activity","volume":"5","author":"Verhoef L. 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