title: Incidence and Predictors of Biological Antirheumatic Drug Discontinuation Attempts among Patients with Rheumatoid Arthritis in Remission: A CORRONA and NinJa Collaborative Cohort Study.
abstract: OBJECTIVE
  We conducted a longitudinal observational study of biological disease-modifying antirheumatic drugs (bDMARD) to describe the proportions of patients with rheumatoid arthritis in remission who discontinued these agents, and to assess the potential predictors of the decision to discontinue.
  
  
  METHODS
  We used data from the US COnsortium of Rheumatology Researchers Of North America (CORRONA) and the Japanese National Database of Rheumatic Diseases by iR-net in Japan (NinJa) registries, and ran parallel analyses. Patients treated with bDMARD who experienced remission (defined by the Clinical Disease Activity Index ≤ 2.8) were included. The outcome of interest was the occurrence of bDMARD discontinuation while in remission. The predictors of discontinuation were assessed in the Cox regression models. Frailty models were also used to examine the effects of individual physicians in the discontinuation decision.
  
  
  RESULTS
  The numbers of eligible patients who were initially in remission were 6263 in the CORRONA and 744 in the NinJa. Among these patients, 10.0% of patients in CORRONA and 11.8% of patients in NinJa discontinued bDMARD while in remission over 5 years, whereas many of the remaining patients lost remission before discontinuing bDMARD. Shorter disease duration was associated with higher rates of discontinuation in both cohorts. In CORRONA, methotrexate use and lower disease activity were also associated with discontinuation. In frailty models, physician random effects were significant in both cohorts.
  
  
  CONCLUSIONS
  Among patients who initially experienced remission while receiving bDMARD, around 10% remained in remission and then discontinued bDMARD in both registries. Several factors were associated with more frequent discontinuation while in remission. Physician preference likely is also an important correlate of bDMARD discontinuation, indicating the need for standardization of practice.
authors.affiliation: From the Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston; University of Massachusetts Medical School, Worcester, Massachusetts; New York University Hospital for Joint Diseases, New York; Albany Medical College, Center for Rheumatology, Albany, New York; Division of Rheumatology, Allergy and Immunology, University of California San Diego, La Jolla, California, USA; Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Immuno-Rheumatology Center, St. Luke's International Hospital, Tokyo; Department of Rheumatology, Kameda Medical Center, Kamogawa; Department of Clinical Research, National Hospital Organization Osaka Minami Medical Center, Kawachinagano, Osaka; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan.K. Yoshida, MD, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Epidemiology, Harvard T.H. Chan School of Public Health; H. Radner, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna; M.D. Mjaavatten, MD, PhD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Diakonhjemmet Hospital; J.D. Greenberg, MD, MPH, New York University Hospital for Joint Diseases; A. Kavanaugh, MD, Division of Rheumatology, Allergy and Immunology, University of California San Diego; M. Kishimoto, MD, PhD, Immuno-Rheumatology Center, St. Luke's International Hospital; K. Matsui, MD, Department of Rheumatology, Kameda Medical Center; M. Okada, MD, Immuno-Rheumatology Center, St. Luke's International Hospital; G. Reed, PhD, University of Massa
authors.forename: Kazuki
authors.initials: K
authors.lastname: Yoshida
authors.affiliation: From the Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston; University of Massachusetts Medical School, Worcester, Massachusetts; New York University Hospital for Joint Diseases, New York; Albany Medical College, Center for Rheumatology, Albany, New York; Division of Rheumatology, Allergy and Immunology, University of California San Diego, La Jolla, California, USA; Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Immuno-Rheumatology Center, St. Luke's International Hospital, Tokyo; Department of Rheumatology, Kameda Medical Center, Kamogawa; Department of Clinical Research, National Hospital Organization Osaka Minami Medical Center, Kawachinagano, Osaka; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan.K. Yoshida, MD, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Epidemiology, Harvard T.H. Chan School of Public Health; H. Radner, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna; M.D. Mjaavatten, MD, PhD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Diakonhjemmet Hospital; J.D. Greenberg, MD, MPH, New York University Hospital for Joint Diseases; A. Kavanaugh, MD, Division of Rheumatology, Allergy and Immunology, University of California San Diego; M. Kishimoto, MD, PhD, Immuno-Rheumatology Center, St. Luke's International Hospital; K. Matsui, MD, Department of Rheumatology, Kameda Medical Center; M. Okada, MD, Immuno-Rheumatology Center, St. Luke's International Hospital; G. Reed, PhD, University of Massa
authors.forename: Helga
authors.initials: H
authors.lastname: Radner
authors.affiliation: From the Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston; University of Massachusetts Medical School, Worcester, Massachusetts; New York University Hospital for Joint Diseases, New York; Albany Medical College, Center for Rheumatology, Albany, New York; Division of Rheumatology, Allergy and Immunology, University of California San Diego, La Jolla, California, USA; Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Immuno-Rheumatology Center, St. Luke's International Hospital, Tokyo; Department of Rheumatology, Kameda Medical Center, Kamogawa; Department of Clinical Research, National Hospital Organization Osaka Minami Medical Center, Kawachinagano, Osaka; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan.K. Yoshida, MD, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Epidemiology, Harvard T.H. Chan School of Public Health; H. Radner, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna; M.D. Mjaavatten, MD, PhD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Diakonhjemmet Hospital; J.D. Greenberg, MD, MPH, New York University Hospital for Joint Diseases; A. Kavanaugh, MD, Division of Rheumatology, Allergy and Immunology, University of California San Diego; M. Kishimoto, MD, PhD, Immuno-Rheumatology Center, St. Luke's International Hospital; K. Matsui, MD, Department of Rheumatology, Kameda Medical Center; M. Okada, MD, Immuno-Rheumatology Center, St. Luke's International Hospital; G. Reed, PhD, University of Massa
authors.forename: Maria D
authors.initials: MD
authors.lastname: Mjaavatten
authors.affiliation: From the Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston; University of Massachusetts Medical School, Worcester, Massachusetts; New York University Hospital for Joint Diseases, New York; Albany Medical College, Center for Rheumatology, Albany, New York; Division of Rheumatology, Allergy and Immunology, University of California San Diego, La Jolla, California, USA; Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Immuno-Rheumatology Center, St. Luke's International Hospital, Tokyo; Department of Rheumatology, Kameda Medical Center, Kamogawa; Department of Clinical Research, National Hospital Organization Osaka Minami Medical Center, Kawachinagano, Osaka; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan.K. Yoshida, MD, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Epidemiology, Harvard T.H. Chan School of Public Health; H. Radner, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna; M.D. Mjaavatten, MD, PhD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Diakonhjemmet Hospital; J.D. Greenberg, MD, MPH, New York University Hospital for Joint Diseases; A. Kavanaugh, MD, Division of Rheumatology, Allergy and Immunology, University of California San Diego; M. Kishimoto, MD, PhD, Immuno-Rheumatology Center, St. Luke's International Hospital; K. Matsui, MD, Department of Rheumatology, Kameda Medical Center; M. Okada, MD, Immuno-Rheumatology Center, St. Luke's International Hospital; G. Reed, PhD, University of Massa
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Greenberg
authors.affiliation: From the Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston; University of Massachusetts Medical School, Worcester, Massachusetts; New York University Hospital for Joint Diseases, New York; Albany Medical College, Center for Rheumatology, Albany, New York; Division of Rheumatology, Allergy and Immunology, University of California San Diego, La Jolla, California, USA; Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Immuno-Rheumatology Center, St. Luke's International Hospital, Tokyo; Department of Rheumatology, Kameda Medical Center, Kamogawa; Department of Clinical Research, National Hospital Organization Osaka Minami Medical Center, Kawachinagano, Osaka; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan.K. Yoshida, MD, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Epidemiology, Harvard T.H. Chan School of Public Health; H. Radner, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna; M.D. Mjaavatten, MD, PhD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Diakonhjemmet Hospital; J.D. Greenberg, MD, MPH, New York University Hospital for Joint Diseases; A. Kavanaugh, MD, Division of Rheumatology, Allergy and Immunology, University of California San Diego; M. Kishimoto, MD, PhD, Immuno-Rheumatology Center, St. Luke's International Hospital; K. Matsui, MD, Department of Rheumatology, Kameda Medical Center; M. Okada, MD, Immuno-Rheumatology Center, St. Luke's International Hospital; G. Reed, PhD, University of Massa
authors.forename: Arthur
authors.initials: A
authors.lastname: Kavanaugh
authors.affiliation: From the Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston; University of Massachusetts Medical School, Worcester, Massachusetts; New York University Hospital for Joint Diseases, New York; Albany Medical College, Center for Rheumatology, Albany, New York; Division of Rheumatology, Allergy and Immunology, University of California San Diego, La Jolla, California, USA; Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Immuno-Rheumatology Center, St. Luke's International Hospital, Tokyo; Department of Rheumatology, Kameda Medical Center, Kamogawa; Department of Clinical Research, National Hospital Organization Osaka Minami Medical Center, Kawachinagano, Osaka; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan.K. Yoshida, MD, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Epidemiology, Harvard T.H. Chan School of Public Health; H. Radner, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna; M.D. Mjaavatten, MD, PhD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Diakonhjemmet Hospital; J.D. Greenberg, MD, MPH, New York University Hospital for Joint Diseases; A. Kavanaugh, MD, Division of Rheumatology, Allergy and Immunology, University of California San Diego; M. Kishimoto, MD, PhD, Immuno-Rheumatology Center, St. Luke's International Hospital; K. Matsui, MD, Department of Rheumatology, Kameda Medical Center; M. Okada, MD, Immuno-Rheumatology Center, St. Luke's International Hospital; G. Reed, PhD, University of Massa
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Kishimoto
authors.affiliation: From the Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston; University of Massachusetts Medical School, Worcester, Massachusetts; New York University Hospital for Joint Diseases, New York; Albany Medical College, Center for Rheumatology, Albany, New York; Division of Rheumatology, Allergy and Immunology, University of California San Diego, La Jolla, California, USA; Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Immuno-Rheumatology Center, St. Luke's International Hospital, Tokyo; Department of Rheumatology, Kameda Medical Center, Kamogawa; Department of Clinical Research, National Hospital Organization Osaka Minami Medical Center, Kawachinagano, Osaka; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan.K. Yoshida, MD, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Epidemiology, Harvard T.H. Chan School of Public Health; H. Radner, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna; M.D. Mjaavatten, MD, PhD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Diakonhjemmet Hospital; J.D. Greenberg, MD, MPH, New York University Hospital for Joint Diseases; A. Kavanaugh, MD, Division of Rheumatology, Allergy and Immunology, University of California San Diego; M. Kishimoto, MD, PhD, Immuno-Rheumatology Center, St. Luke's International Hospital; K. Matsui, MD, Department of Rheumatology, Kameda Medical Center; M. Okada, MD, Immuno-Rheumatology Center, St. Luke's International Hospital; G. Reed, PhD, University of Massa
authors.forename: Kazuo
authors.initials: K
authors.lastname: Matsui
authors.affiliation: From the Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston; University of Massachusetts Medical School, Worcester, Massachusetts; New York University Hospital for Joint Diseases, New York; Albany Medical College, Center for Rheumatology, Albany, New York; Division of Rheumatology, Allergy and Immunology, University of California San Diego, La Jolla, California, USA; Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Immuno-Rheumatology Center, St. Luke's International Hospital, Tokyo; Department of Rheumatology, Kameda Medical Center, Kamogawa; Department of Clinical Research, National Hospital Organization Osaka Minami Medical Center, Kawachinagano, Osaka; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan.K. Yoshida, MD, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Epidemiology, Harvard T.H. Chan School of Public Health; H. Radner, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna; M.D. Mjaavatten, MD, PhD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Diakonhjemmet Hospital; J.D. Greenberg, MD, MPH, New York University Hospital for Joint Diseases; A. Kavanaugh, MD, Division of Rheumatology, Allergy and Immunology, University of California San Diego; M. Kishimoto, MD, PhD, Immuno-Rheumatology Center, St. Luke's International Hospital; K. Matsui, MD, Department of Rheumatology, Kameda Medical Center; M. Okada, MD, Immuno-Rheumatology Center, St. Luke's International Hospital; G. Reed, PhD, University of Massa
authors.forename: Masato
authors.initials: M
authors.lastname: Okada
authors.affiliation: From the Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston; University of Massachusetts Medical School, Worcester, Massachusetts; New York University Hospital for Joint Diseases, New York; Albany Medical College, Center for Rheumatology, Albany, New York; Division of Rheumatology, Allergy and Immunology, University of California San Diego, La Jolla, California, USA; Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Immuno-Rheumatology Center, St. Luke's International Hospital, Tokyo; Department of Rheumatology, Kameda Medical Center, Kamogawa; Department of Clinical Research, National Hospital Organization Osaka Minami Medical Center, Kawachinagano, Osaka; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan.K. Yoshida, MD, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Epidemiology, Harvard T.H. Chan School of Public Health; H. Radner, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna; M.D. Mjaavatten, MD, PhD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Diakonhjemmet Hospital; J.D. Greenberg, MD, MPH, New York University Hospital for Joint Diseases; A. Kavanaugh, MD, Division of Rheumatology, Allergy and Immunology, University of California San Diego; M. Kishimoto, MD, PhD, Immuno-Rheumatology Center, St. Luke's International Hospital; K. Matsui, MD, Department of Rheumatology, Kameda Medical Center; M. Okada, MD, Immuno-Rheumatology Center, St. Luke's International Hospital; G. Reed, PhD, University of Massa
authors.forename: George
authors.initials: G
authors.lastname: Reed
authors.affiliation: From the Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston; University of Massachusetts Medical School, Worcester, Massachusetts; New York University Hospital for Joint Diseases, New York; Albany Medical College, Center for Rheumatology, Albany, New York; Division of Rheumatology, Allergy and Immunology, University of California San Diego, La Jolla, California, USA; Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Immuno-Rheumatology Center, St. Luke's International Hospital, Tokyo; Department of Rheumatology, Kameda Medical Center, Kamogawa; Department of Clinical Research, National Hospital Organization Osaka Minami Medical Center, Kawachinagano, Osaka; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan.K. Yoshida, MD, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Epidemiology, Harvard T.H. Chan School of Public Health; H. Radner, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna; M.D. Mjaavatten, MD, PhD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Diakonhjemmet Hospital; J.D. Greenberg, MD, MPH, New York University Hospital for Joint Diseases; A. Kavanaugh, MD, Division of Rheumatology, Allergy and Immunology, University of California San Diego; M. Kishimoto, MD, PhD, Immuno-Rheumatology Center, St. Luke's International Hospital; K. Matsui, MD, Department of Rheumatology, Kameda Medical Center; M. Okada, MD, Immuno-Rheumatology Center, St. Luke's International Hospital; G. Reed, PhD, University of Massa
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Saeki
authors.affiliation: From the Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston; University of Massachusetts Medical School, Worcester, Massachusetts; New York University Hospital for Joint Diseases, New York; Albany Medical College, Center for Rheumatology, Albany, New York; Division of Rheumatology, Allergy and Immunology, University of California San Diego, La Jolla, California, USA; Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Immuno-Rheumatology Center, St. Luke's International Hospital, Tokyo; Department of Rheumatology, Kameda Medical Center, Kamogawa; Department of Clinical Research, National Hospital Organization Osaka Minami Medical Center, Kawachinagano, Osaka; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan.K. Yoshida, MD, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Epidemiology, Harvard T.H. Chan School of Public Health; H. Radner, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna; M.D. Mjaavatten, MD, PhD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Diakonhjemmet Hospital; J.D. Greenberg, MD, MPH, New York University Hospital for Joint Diseases; A. Kavanaugh, MD, Division of Rheumatology, Allergy and Immunology, University of California San Diego; M. Kishimoto, MD, PhD, Immuno-Rheumatology Center, St. Luke's International Hospital; K. Matsui, MD, Department of Rheumatology, Kameda Medical Center; M. Okada, MD, Immuno-Rheumatology Center, St. Luke's International Hospital; G. Reed, PhD, University of Massa
authors.forename: Shigeto
authors.initials: S
authors.lastname: Tohma
authors.affiliation: From the Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston; University of Massachusetts Medical School, Worcester, Massachusetts; New York University Hospital for Joint Diseases, New York; Albany Medical College, Center for Rheumatology, Albany, New York; Division of Rheumatology, Allergy and Immunology, University of California San Diego, La Jolla, California, USA; Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Immuno-Rheumatology Center, St. Luke's International Hospital, Tokyo; Department of Rheumatology, Kameda Medical Center, Kamogawa; Department of Clinical Research, National Hospital Organization Osaka Minami Medical Center, Kawachinagano, Osaka; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan.K. Yoshida, MD, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Epidemiology, Harvard T.H. Chan School of Public Health; H. Radner, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna; M.D. Mjaavatten, MD, PhD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Diakonhjemmet Hospital; J.D. Greenberg, MD, MPH, New York University Hospital for Joint Diseases; A. Kavanaugh, MD, Division of Rheumatology, Allergy and Immunology, University of California San Diego; M. Kishimoto, MD, PhD, Immuno-Rheumatology Center, St. Luke's International Hospital; K. Matsui, MD, Department of Rheumatology, Kameda Medical Center; M. Okada, MD, Immuno-Rheumatology Center, St. Luke's International Hospital; G. Reed, PhD, University of Massa
authors.forename: Joel
authors.initials: J
authors.lastname: Kremer
authors.affiliation: From the Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston; University of Massachusetts Medical School, Worcester, Massachusetts; New York University Hospital for Joint Diseases, New York; Albany Medical College, Center for Rheumatology, Albany, New York; Division of Rheumatology, Allergy and Immunology, University of California San Diego, La Jolla, California, USA; Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Immuno-Rheumatology Center, St. Luke's International Hospital, Tokyo; Department of Rheumatology, Kameda Medical Center, Kamogawa; Department of Clinical Research, National Hospital Organization Osaka Minami Medical Center, Kawachinagano, Osaka; Department of Rheumatology, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan.K. Yoshida, MD, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Epidemiology, Harvard T.H. Chan School of Public Health; H. Radner, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Internal Medicine III, Division of Rheumatology, Medical University of Vienna; M.D. Mjaavatten, MD, PhD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Diakonhjemmet Hospital; J.D. Greenberg, MD, MPH, New York University Hospital for Joint Diseases; A. Kavanaugh, MD, Division of Rheumatology, Allergy and Immunology, University of California San Diego; M. Kishimoto, MD, PhD, Immuno-Rheumatology Center, St. Luke's International Hospital; K. Matsui, MD, Department of Rheumatology, Kameda Medical Center; M. Okada, MD, Immuno-Rheumatology Center, St. Luke's International Hospital; G. Reed, PhD, University of Massa
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Solomon
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy*; D001688:Biological Products / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009656:North America; D016016:Proportional Hazards Models; D012008:Recurrence; D012044:Regression Analysis; D012074:Remission Induction; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D028761:Withholding Treatment
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products
keywords: AFFILIATIONS; ANTIRHEUMATIC AGENTS; BIOLOGICAL ANTIRHEUMATIC AGENTS; DISCONTINUATION; REMISSION; RHEUMATOID ARTHRITIS