Three-year cost-effectiveness analysis of the DRESS study: protocolised tapering is key

The DRESS (Dose REduction Strategy of Subcutaneous TNF inhibitors) study previously showed clinical non-inferiority and superior cost-effectiveness of disease activity-guided tapering of tumour necrosis factor inhibitors (TNFi) (dose reduction, DR group) over full dose continuation (usual care, UC group) in patients with rheumatoid arthritis (RA) with low disease activity.1 2 The safety and efficacy of this strategy were maintained up to 3 years, with a large reduction in TNFi use.3 During the extension phase, the majority of the UC group attempted dose reduction. This prevented a valid comparison of disease activity-guided tapering with full dose continuation over the entire study period but presented an opportunity to make the following comparisons: 1. Tapering long-term results (in the DR group 18–36 months) versus short-term results (in the DR group 0–18 months). 2. Tapering at the rheumatologist’s discretion (in the UC group 18–36 months) compared with full dose continuation (in the UC group 0–18 months). …