有高达30%的RA患者正在接受生物（b）疾病修饰性抗风湿药物（DMARDs）单一治疗。单一治疗白细胞介素（IL）-6抑制剂（i）和Janus激酶（JAK）-i已被证明是有效的。目前还不清楚患者是否可以削减用作单一治疗的靶向治疗（bDMARDs和JAK-i）。为了确定RA患者可以逐渐减少靶向单一治疗的可行性，我们在Medline，Embase和Cochrane图书馆中进行了文献检索，搜索了2014年1月至2021年8月的前瞻性研究，报告了RA患者减少靶向单一治疗后的缓解结果。符合纳入标准的5项随机研究评估了肿瘤坏死因子抑制剂，托珠单抗，阿巴塞普和巴瑞替尼单一治疗的逐渐削减。研究结果有异质性。三项试验研究了早期RA。三项研究逐渐减少治疗，包括1项剂量减少研究。三项研究逐渐削减了生物药物和传统合成（cs）-DMARDs。没有研究将停止靶向单一治疗与继续治疗进行比较。所有停止靶向单一治疗的研究中，缓解率低，范围在14%至28%之间。剂量减少研究报告的缓解率最高，为72%。研究早期RA的试验报告了在减少治疗后的缓解率，范围为27%至72%。在已确立的RA中逐渐减少治疗的试验报告了14%至20%的缓解率。已发表的文献中存在着关于减少靶向单一治疗的缺口。停止靶向单一治疗不太可能维持RA的疾病控制。剂量减少策略和早期治疗可能与更成功的减少有关，并需要进行进一步研究。 版权所有© Bentham Science Publishers；如有任何疑问，请发送电子邮件至epub@benthamscience.net。

Up to 30% of patients with RA are being treated with biologic (b)-disease modifying anti-rheumatic drugs (DMARDs) as monotherapy. Monotherapy with Interleukin (IL)-6 inhibitors(i) and Janus-kinase (JAK)-i has been shown to be effective. Whether patients can taper targeted therapy (bDMARDs and JAK-i) used as monotherapy (targeted monotherapy) is unknown.To determine the feasibility of tapering of targeted monotherapy in patients with controlled RA.We conducted a literature search in Medline, Embase and Cochrane Library for prospective studies reporting remission outcomes after tapering targeted monotherapy in RA patients, from 1/2014 - 8 /2021.5 randomized studies which met our inclusion criteria, evaluating tapering of monotherapy with tumor necrosis factor-inhibitors, tocilizumab, abatacept and baricitinib in RA. Studies were heterogeneous. Three trials studied early RA. Three studies gradually tapered therapy, including 1 dose reduction study. Three studies tapered both biological and conventional-synthetic (cs)-DMARDs. No study compared stopping targeted monotherapy to continuing it. Remission rates were low 14-28% across all studies that stopped targeted monotherapy. The highest remission rate of 72% was reported by the dose reduction study. Trials that studied early RA reported remission rates after tapering ranging 27-72%. Trials tapering therapy in established RA reported rates of remission from 14-20%.There is a crucial gap in published literature to inform on tapering targeted monotherapy in patients with RA. Stopping targeted monotherapy is unlikely to maintain disease control in RA. Dose reduction strategies and early treatment of disease may be associated with more successful tapering, and warrant future study.Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.