How do you approach tapering off JAK inhibitors in patients with rheumatoid arthritis who are in sustained remission?

My approach to treatment changes for RA patients who are in remission is usually not specific to the kind of medications they are on. Unless the patient has adverse events, I tend to continue the medication or combination of medications that got them into remission.

As we know, RA is a chronic condi...

If you believe your patient is in sustained remission, which is difficult to access with certainty, I would slowly decrease the dose, making changes about 6-8 weeks. My usual starting dose is 11mg, so I take it down to 5 mg bid, then 5 then off. At each dose reduction, if there is disease activity, ...

Signs that a patient may be in remission include sustained (for me, > 2 years) normal ESR, CRP, and if at one time RF + a loss of production of the RF. I follow radiographs, and unchanged radiographs after a serial evaluation is helpful. I like ultrasound assessment and look for major sites as outli...