JAK Inhibitor Dose TAPering Strategy Study

Inclusion criteria

• will be
• Aged ≥ 18 years at baseline.
• Rheumatoid arthritis defined by the ACR/EULAR criteria.
• Treated with a JAK inhibitor, full dose for at least 6 months.
• The JAK inhibitor is prescribed as monotherapy or combined with a csDMARD with a stable dosage for at least 3 months before inclusion.
• Being in LDA (CDAI≤10) for at least 6 months.
• With a CRP level below the laboratory standard within the month before the inclusion visit.
• Women of childbearing potential (WCBP) must have a negative pregnancy test before starting study
• The non-inclusion criteria will be:
• Concomitant disease needing to be treated by the JAK inhibitor at full-dose (for example inflammatory bowel disease).
• Patient with a history of JAK-inhibitor dose reduction/spacing before enrollment in the study with the JAK-inhibitor currently being taken.
• Evidence of flare-up within the last 6 months prior to the inclusion.
• Patient who received glucocorticoids \> 5mg/day in the 3 months prior the inclusion because of the disease activity of the RA.
• Patient requiring corticoid joint injections in the 3 months prior to inclusion or with scheduled joint injections, to control disease activity.
• Patient at risk for complication according to the ANSM (60) (current or past smokers, patients at risk of VTE, cancer or major cardiovascular problems, aged ≥ 65 years) at baseline AND currently taking baricitinib or filgotinib.
• Patient taking associated bDMARD (including anti-TNF, anti-IL6, anti-CD20, abatacept, anti-IL17, anti-IL12/23, anti-IL23, anti-IL1, anti-BAFF, anti-IL5 pathways).
• Patient taking immunotherapy for neoplasia.
• Surgery scheduled in the next 12 months.
• Fibromyalgia according to the physician's opinion.
• Anticipated poor compliance with the strategy.
• Patient with any condition that would prevent participation in the study and completion of the study procedures, including language limitation.
• Alcohol and/or drug misuse as determined by the investigator.
• Pregnancy or breastfeeding.
• Non-affiliation to the French Social Security System.
• Patient unwilling to sign the informed consent form.
• Patient under legal protection.