Tapering and withdrawal of methotrexate and biologics in patients with rheumatoid arthritis

INTERVENTION: control: continue the present treatment intervention: reduce the dosage of methotrexate by half every 3 months and discontinue intervention: extend the interval of biologics to one and a half times every 3 months and discontinue CONDITION: Rheumatoid arthritis PRIMARY OUTCOME: Rate of sustaining remission in patients who have continued the present therapy, tapered and discontinued methotrexate, and extended the interval of biologics 52 weeks after starting tapering. SECONDARY OUTCOME: Disease activity, clinical characteristics, serological markers, rate of adverse events, FACS analysis, blood concentration of each drugs and antibodies against each drugs, serological concentration of cytokines and chemokines in patients who could successfully taper and discontinue anti‐rheumatic drugs and who could not at the point anti‐rheumatic drugs are started to be tapered, anti‐rheumatic drugs are discontinued, and 52 weeks after anti‐rheumatic drugs are started to be tapered. INCLUSION CRITERIA: Patients of rheumatoid arthritis treated with methotrexate and/or biologics who have sustained remission(DAS28<2.6) for 6 months