N | Disease flare | Withdrawal effects | Side effects when previously stopped | Unsuccessful when previously stopped | Medication may no longer work as well | No concerns | |
Systemic glucocorticoids | 762 | 443 (58.1) | 188 (24.7) | 26 (3.4) | 28 (3.7) | 15 (2.0) | 62 (8.1) |
NSAIDs | 740 | 412 (55.7) | 18 (2.4) | 29 (3.9) | 13 (1.8) | 14 (1.9) | 254 (34.3) |
Antimalarials | 733 | 518 (70.7) | 24 (3.3) | 8 (1.1) | 8 (1.1) | 18 (2.5) | 157 (21.4) |
Methotrexate | 855 | 616 (72.0) | 13 (1.5) | 10 (1.2) | 3 (0.4) | 39 (4.6) | 174 (20.4) |
Other csDMARDs* | 513 | 372 (72.5) | 13 (2.5) | 6 (1.2) | 8 (1.6) | 19 (3.7) | 95 (18.5) |
Mycophenolate | 228 | 169 (74.8) | 8 (3.5) | 9 (4.0) | 2 (0.9) | 7 (3.1) | 33 (14.6) |
Other antimetabolites† | 21 | 11 (52.4) | 1 (4.8) | 1 (4.8) | 0 (0) | 1 (4.8) | 7 (33.3) |
Abatacept | 71 | 53 (74.6) | 3 (4.2) | 1 (1.4) | 0 (0) | 5 (7.0) | 9 (12.7) |
Rituximab | 162 | 131 (81.9) | 1 (0.6) | 3 (1.9) | 2 (1.3) | 7 (4.4) | 18 (11.3) |
TNF inhibitors | 493 | 369 (75.5) | 6 (1.2) | 5 (1.0) | 4 (0.8) | 73 (14.8) | 36 (7.4) |
Other biologics‡ | 206 | 157 (77.3) | 4 (2.0) | 2 (1.0) | 3 (1.5) | 21 (10.2) | 19 (9.4) |
JAK inhibitors | 121 | 104 (86.0) | 2 (1.7) | 1 (0.8) | 0 (0) | 7 (5.8) | 7 (5.8) |
IVIG | 102 | 80 (79.2) | 2 (2.0) | 1 (1.0) | 1 (1.0) | 1 (1.0) | 17 (16.8) |
*Includes apremilast, azathioprine, 6-mercaptopurine, leflunomide, sulfasalazine.
†Includes calcineurin inhibitors (ciclosporin, tacrolimus), cyclophosphamide, thalidomide and lenalidomide.
‡Includes belimumab, IL-1 inhibitors (anakinra, canakimumab, rilonacept), IL-6 inhibitors (tocilizumab, sarilumab, siltuximab), IL-12/IL-23 inhibitors (ustekinumab, guselkumab), IL-17 inhibitors (secukinumab, ixekizumab), eculizumab, mepolizumab and vedolizumab.
csDMARDs, conventional synthetic DMARDs; DMARDs, drug-modifying antirheumatic drugs; IL, interleukin; IVIG, intravenous immunoglobulin; JAK, Janus kinase inhibitors; NSAIDs, non-steroidal anti-inflammatory drugs; TNF, tumour necrosis factor.