A Norwegian study comparing treatment strategies in rheumatoid arthritis after achieving long-term good disease control

project manager

About the project

Rheumatoid arthritis is an inflammatory disease that affects 0.5-1% of the population. The disease is characterized by joint swelling and joint pain, which can lead to joint damage and reduced function. With the use of modern treatment strategies, which include disease-modifying drugs, good disease control without signs of inflammation has become an achievable goal in an increasing number of people. However, there has been no professional consensus or clear guidelines on how to treat this group further; should one continue with a stable dose of medication, or taper and eventually discontinue treatment?

ARCTIC REWIND is a multicenter randomized controlled trial whose main objective is to investigate whether a strategy where the disease-modifying treatment is tapered and possibly discontinued is not inferior to continued stable treatment in terms of maintaining good disease control. In addition, the study will provide much needed data for research on more personalized treatment.

Who can participate?

The study included adults with rheumatoid arthritis where there had been no evidence of disease activity in the last 12 months.

Both recruitment and follow-up of those included have been completed.

Project arrangement

In one study arm, treatment was tapered and eventually discontinued; in the other, participants continued unchanged treatment. Both groups were followed with regular check-ups every 4 months for 3 years with careful monitoring for signs of flare-ups of disease activity (clinical examination, blood tests and patient-reported outcome measures), as well as recording and management of potential side effects. In addition, annual ultrasound examination, X-ray of hands and feet, MRI of dominant hand and biobank were performed.

The study was split in two; one part included people using synthetic disease-modifying therapies, the other included people using biological drugs (TNF inhibitors).


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