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We used GRADE methodology to develop recommendations for dose reduction and discontinuation of b\/tsDMARD in people with rheumatoid arthritis (RA), axial spondyloarthritis (AxSpA) and psoriatic arthritis (PsA) who have achieved a low disease activity state or remission. The recommendations form part of the Australian Living Guideline for the Pharmacological Management of Inflammatory Arthritis, an NHMRC\u2010endorsed \u2018living\u2019 guideline, in which recommendations are updated in near real\u2010time as new evidence emerges. Conditional recommendations were made in favour of dose reduction in RA and AxSpA but not in PsA. Abrupt discontinuation of b\/tsDMARD is not recommended in any of the three diseases.<\/jats:p>","DOI":"10.1111\/imj.15816","type":"journal-article","created":{"date-parts":[[2022,5,14]],"date-time":"2022-05-14T07:54:46Z","timestamp":1652514886000},"page":"1799-1805","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Australian recommendations on tapering of biologic and targeted synthetic disease\u2010modifying anti\u2010rheumatic drugs in inflammatory arthritis"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7417-7691","authenticated-orcid":false,"given":"Samuel L.","family":"Whittle","sequence":"first","affiliation":[{"name":"Rheumatology Unit Queen Elizabeth Hospital  Adelaide South Australia Australia"},{"name":"Monash\u2010Cabrini Department of Musculoskeletal Health and Clinical Epidemiology Cabrini Health  Melbourne Victoria Australia"},{"name":"Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa","family":"Glennon","sequence":"additional","affiliation":[{"name":"Monash\u2010Cabrini Department of Musculoskeletal Health and Clinical Epidemiology Cabrini Health  Melbourne Victoria Australia"},{"name":"Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renea V.","family":"Johnston","sequence":"additional","affiliation":[{"name":"Monash\u2010Cabrini Department of Musculoskeletal Health and Clinical Epidemiology Cabrini Health  Melbourne Victoria Australia"},{"name":"Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jodie C.","family":"Avery","sequence":"additional","affiliation":[{"name":"Monash\u2010Cabrini Department of Musculoskeletal Health and Clinical Epidemiology Cabrini Health  Melbourne Victoria Australia"},{"name":"Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"},{"name":"School of Medicine The University of Adelaide  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Simon","family":"Bell","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy and Pharmaceutical Sciences Monash University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sue E.","family":"Brennan","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Fong","sequence":"additional","affiliation":[{"name":"Eastern Clinical Research Unit Eastern Health Box Hill Hospital and Monash University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pravin","family":"Hissaria","sequence":"additional","affiliation":[{"name":"School of Medicine The University of Adelaide  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ben","family":"Horgan","sequence":"additional","affiliation":[{"name":"Consumer and Community Involvement Program Western Australian Health Translation Network  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean","family":"O'Neill","sequence":"additional","affiliation":[{"name":"Sydney Musculoskeletal Health Flagship University of Sydney Northern Clinical School, and Royal North Shore Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huai Leng","family":"Pisaniello","sequence":"additional","affiliation":[{"name":"School of Medicine The University of Adelaide  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lyndal","family":"Trevena","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glen A.","family":"Whittaker","sequence":"additional","affiliation":[{"name":"Discipline of Podiatry, School of Allied Health, Human Services and Sport La Trobe University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita","family":"Wluka","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0597-0933","authenticated-orcid":false,"given":"Rachelle","family":"Buchbinder","sequence":"additional","affiliation":[{"name":"Monash\u2010Cabrini Department of Musculoskeletal Health and Clinical Epidemiology Cabrini Health  Melbourne Victoria Australia"},{"name":"Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,10,20]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40271-019-00403-9"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja15.00716"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keab330"},{"key":"e_1_2_5_5_1","first-page":"39","article-title":"ARA member survey to identify priority questions for a living guideline for the pharmacological management of rheumatoid arthritis","volume":"50","author":"Whittle S","year":"2020","journal-title":"Intern Med J"},{"key":"e_1_2_5_6_1","volume-title":"Guidelines for Guidelines Handbook","author":"National Health and Medical Research Council (NHMRC)","year":"2016"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2017.08.009"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i2016"},{"key":"e_1_2_5_9_1","unstructured":"GRADE Handbook.McMaster University;2013[cited 2022 Feb 7]. 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