Which statement best reflects de-escalation of RA therapy?

• A. Always gradual reduction and involve shared decision
• B. Discontinue all medications immediately
• C. Do not adjust therapy
• D. Increase dose

Answer: (A)

During de-escalation of RA therapy, the goal is to reduce medication exposure while keeping inflammation under control. The best approach is to taper treatments gradually and involve the patient in the decision-making process. This allows close monitoring of disease activity and the option to adjust promptly if a flare occurs. In practice, after sustained remission or low disease activity for several months, one therapy can be tapered or stopped step by step, rather than abruptly stopping all medications. This patient-centered, cautious taper helps minimize risks of flare and joint damage while respecting patient preferences and values. Abruptly discontinuing everything, not adjusting therapy, or simply increasing the dose would all contradict the goal of safely reducing therapy while maintaining control.