#4-26E. Tapering Strategies in Rheumatoid Arthritis: The SORAIRO Trial (ARD, 2026)

Are you struggling with the decision of when and how to taper medications in patients with rheumatoid arthritis who have achieved treatment targets? The SORAIRO trial, a multicenter, open-label, randomized non-inferiority study, investigated whether spacing the administration of the next-generation TNF inhibitor ozoralizumab or reducing methotrexate (MTX) doses is comparable to continuing standard treatment in patients with low disease activity or remission. The study's key finding reveals that while tapering medications falls short of maintaining targets for patients with mere low disease activity, both extending the TNF inhibitor interval and reducing the MTX dose are reasonable and effective options for those already in stable baseline remission. When critically appraising this paper, listeners should be cautious of its open-label design, which could introduce evaluation bias or nocebo effects, as well as the relatively short four-week period used to confirm stable disease prior to enrollment. For practicing physicians, this trial provides crucial evidence that tapering should be strictly reserved for patients achieving deep remission, offering a practical framework to safely minimize adverse events and healthcare costs while maintaining optimal disease control.

Citation: Yuki Imai, Yuko Kaneko, et al. Spacing of a TNF inhibitor or dose reduction of methotrexate vs continued treatment in patients with rheumatoid arthritis in remission or low disease activity: a randomised, controlled trial (SORAIRO trial). Annals of the Rheumatic Diseases. 2026. DOI: 10.1016/j.ard.2026.02.004

Disclaimer: This audio summary is based on personal interpretation and does not guarantee the exact content of the original paper. Please refer to the original article for details.