somewordstoolate/Q2CRBench-3 huggingface dataset:
Guideline: 2021 ACR RA
Clinical question: Should patients with RA on their first TNF Inhibitor who are NOT at target, switch to a 2nd TNF Inhibitor or switch to a boDMARD targeting a different molecule or to a tsDMARD?
Population: Patients with RA on DMARDs who are in low disease activity
Intervention: Taper off DMARDs (as long as the patient remains on at least one DMARD)
Comparator: Continue DMARDs at same doses
Outcome: Death (follow up: 1 year)
Importance: IMPORTANT

Evidence assessment:
GRADE: Risk of bias: result: NOT_SERIOUS
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: VERY_SERIOUS
rationales: Small number of events
CI includes both values suggesting benefit and values suggesting harm
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: LOW
No of participants: Continue DMARDs at same doses: 2/202 (1.0%)
Taper off DMARDs: 0/202 (0.0%)
Effect: Relative Effect (95% CI): RR 5.00 (0.24 to 103.50)
Absolute Effect (95% CI): 0 fewer per 1,000 (from 0 fewer to 0 fewer)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with RA on DMARDs who are in remission gradually taper off DMARDs, Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD), or continue DMARDS at the same doses?
Population: Patients with RA on DMARDs in remission
Intervention: Taper off DMARDs (as long as the patient remains on at least one DMARD)
Comparator: Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD)
Outcome: Disease activity (follow up: 9 months; assessed with: ACR 20)
Importance: CRITICAL

Evidence assessment:
GRADE: Risk of bias: result: SERIOUS
rationales: Downgraded by one level due to serious risk of bias. Lack of allocation concealment, incomplete outcome data and selective reporting.
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: SERIOUS
rationales: Downgraded by one level due to serious imprecision. Confidence interval includes both values suggesting no effect and values suggesting benefit.
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: LOW
No of participants: Taper off DMARDs: 56/63 (88.9%)
Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD): 48/63 (76.2%)
Effect: Relative Effect (95% CI): RR 1.17 (0.99 to 1.37)
Absolute Effect (95% CI): 130 more per 1,000 (from 8 fewer to 282 more)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with RA on DMARDs who are in remission gradually taper off DMARDs, Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD), or continue DMARDS at the same doses?
Population: Patients with RA on DMARDs in remission
Intervention: Taper off DMARDs (as long as the patient remains on at least one DMARD)
Comparator: Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD)
Outcome: Disease activity (follow up: 9 months; assessed with: ACR 50)
Importance: CRITICAL

Evidence assessment:
GRADE: Risk of bias: result: SERIOUS
rationales: Downgraded by one level due to serious risk of bias. Lack of allocation concealment, incomplete outcome data and selective reporting.
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: VERY_SERIOUS
rationales: Downgraded by two levels due to very serious imprecision. Confidence interval includes both values suggesting benefit and values suggesting harm.
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: VERY LOW
No of participants: Taper off DMARDs: 49/63 (77.8%)
Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD): 45/63 (71.4%)
Effect: Relative Effect (95% CI): RR 1.09 (0.89 to 1.34)
Absolute Effect (95% CI): 64 more per 1,000 (from 79 fewer to 243 more)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with RA on DMARDs who are in remission gradually taper off DMARDs, Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD), or continue DMARDS at the same doses?
Population: Patients with RA on DMARDs in remission
Intervention: Taper off DMARDs (as long as the patient remains on at least one DMARD)
Comparator: Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD)
Outcome: Disease activity (follow up: 9 months; assessed with: ACR 70)
Importance: CRITICAL

Evidence assessment:
GRADE: Risk of bias: result: SERIOUS
rationales: Downgraded by one level due to serious risk of bias. Lack of allocation concealment, incomplete outcome data and selective reporting.
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: VERY_SERIOUS
rationales: Downgraded by two levels due to very serious imprecision. Confidence interval includes both values suggesting benefit and values suggesting harm.
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: VERY LOW
No of participants: Taper off DMARDs: 45/63 (71.4%)
Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD): 39/63 (61.9%)
Effect: Relative Effect (95% CI): RR 1.15 (0.90 to 1.48)
Absolute Effect (95% CI): 93 more per 1,000 (from 62 fewer to 297 more)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with RA on DMARDs who are in remission gradually taper off DMARDs, Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD), or continue DMARDS at the same doses?
Population: Patients with RA on DMARDs in remission
Intervention: Taper off DMARDs (as long as the patient remains on at least one DMARD)
Comparator: Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD)
Outcome: Disease activity (follow up: 9 months; assessed with: DAS28-ESR (Lower values – > benefit) (MCID -1.17)
Importance: CRITICAL

Evidence assessment:
GRADE: Risk of bias: result: SERIOUS
rationales: Downgraded by one level due to serious risk of bias. Lack of allocation concealment, incomplete outcome data and selective reporting.
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: SERIOUS
rationales: Downgraded by one level due to serious imprecision. Confidence interval includes both values suggesting no effect and values suggesting benefit.
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: LOW
No of participants: Taper off DMARDs: 63
Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD): 65
Effect: Relative Effect (95% CI): -
Absolute Effect (95% CI): MD 0.7 lower (1.25 lower to 0.15 lower)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with RA on DMARDs who are in remission gradually taper off DMARDs, Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD), or continue DMARDS at the same doses?
Population: Patients with RA on DMARDs in remission
Intervention: Taper off DMARDs (as long as the patient remains on at least one DMARD)
Comparator: Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD)
Outcome: Remission (follow up: 9 months; assessed with: DAS28ESR < 2.6)
Importance: CRITICAL

Evidence assessment:
GRADE: Risk of bias: result: SERIOUS
rationales: Downgraded by one level due to serious risk of bias. Lack of allocation concealment, incomplete outcome data and selective reporting.
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: NOT_SERIOUS
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: MODERATE
No of participants: Taper off DMARDs: 50/63 (79.4%)
Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD): 35/65 (53.8%)
Effect: Relative Effect (95% CI): RR 1.47 (1.14 to 1.91)
Absolute Effect (95% CI): 253 more per 1,000 (from 75 more to 490 more)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with RA on DMARDs who are in remission gradually taper off DMARDs, Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD), or continue DMARDS at the same doses?
Population: Patients with RA on DMARDs in remission
Intervention: Taper off DMARDs (as long as the patient remains on at least one DMARD)
Comparator: Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD)
Outcome: Flare (follow up: 12 months)
Importance: CRITICAL

Evidence assessment:
GRADE: Risk of bias: result: NOT_SERIOUS
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: VERY_SERIOUS
rationales: Downgraded by two levels due to very serious imprecision. Very low number of events.
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: LOW
No of participants: Taper off DMARDs: 3/126 (2.4%)
Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD): 10/79 (12.7%)
Effect: Relative Effect (95% CI): RR 0.19 (0.05 to 0.66)
Absolute Effect (95% CI): 103 fewer per 1,000 (from 120 fewer to 43 fewer)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with RA on DMARDs who are in remission gradually taper off DMARDs, Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD), or continue DMARDS at the same doses?
Population: Patients with RA on DMARDs in remission
Intervention: Taper off DMARDs (as long as the patient remains on at least one DMARD)
Comparator: Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD)
Outcome: Radiographic progression (follow up: 9 months; assessed with: mTSS (Lower values – > benefit) (MCID 4.6)
Importance: IMPORTANT

Evidence assessment:
GRADE: Risk of bias: result: SERIOUS
rationales: Downgraded by one level due to serious risk of bias. Lack of allocation concealment, incomplete outcome data and selective reporting.
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: NOT_SERIOUS
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: MODERATE
No of participants: Taper off DMARDs: 63
Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD): 65
Effect: Relative Effect (95% CI): -
Absolute Effect (95% CI): MD 0.1 higher (0.34 lower to 0.54 higher)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with RA on DMARDs who are in remission gradually taper off DMARDs, Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD), or continue DMARDS at the same doses?
Population: Patients with RA on DMARDs in remission
Intervention: Taper off DMARDs (as long as the patient remains on at least one DMARD)
Comparator: Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD)
Outcome: Quality of Life (follow up: 9 months; assessed with: SF-36 PCS (Higher values – > benefit) (MCID 4.4)
Importance: IMPORTANT

Evidence assessment:
GRADE: Risk of bias: result: SERIOUS
rationales: Downgraded by one level due to serious risk of bias. Lack of allocation concealment, incomplete outcome data and selective reporting.
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: SERIOUS
rationales: Downgraded by one level due to serious imprecision. Confidence interval includes both values suggesting no effect and values suggesting benefit.
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: LOW
No of participants: Taper off DMARDs: 63
Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD): 65
Effect: Relative Effect (95% CI): -
Absolute Effect (95% CI): MD 2.3 higher (0.47 lower to 5.07 higher)(The study PRIZE found that the RR of improvement in SF-36 PCS (≥ 5 change from baseline) was 1.03 (95%CI 0.86 to 1.24), absolute risk increase 23 more per 1000 (95%CI 108 fewer to 185 more).)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with RA on DMARDs who are in remission gradually taper off DMARDs, Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD), or continue DMARDS at the same doses?
Population: Patients with RA on DMARDs in remission
Intervention: Taper off DMARDs (as long as the patient remains on at least one DMARD)
Comparator: Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD)
Outcome: Quality of Life (follow up: 9 months; assessed with: SF-36 MCS (Higher values – > benefit) (MCID 3.1)
Importance: IMPORTANT

Evidence assessment:
GRADE: Risk of bias: result: SERIOUS
rationales: Downgraded by one level due to serious risk of bias. Lack of allocation concealment, incomplete outcome data and selective reporting.
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: SERIOUS
rationales: Downgraded by one level due to serious imprecision. Confidence interval includes both values suggesting no effect and values suggesting benefit.
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: LOW
No of participants: Taper off DMARDs: 63
Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD): 65
Effect: Relative Effect (95% CI): -
Absolute Effect (95% CI): MD 1.8 higher (0.97 lower to 4.57 higher)(The study PRIZE found that the RR of improvement in SF-36 MCS (≥ 5 change from baseline) was 1.27 (95%CI 0.91 to 1.78), absolute risk increase 125 more per 1000 (95%CI 42 fewer to 360 more).)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with RA on DMARDs who are in remission gradually taper off DMARDs, Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD), or continue DMARDS at the same doses?
Population: Patients with RA on DMARDs in remission
Intervention: Taper off DMARDs (as long as the patient remains on at least one DMARD)
Comparator: Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD)
Outcome: Fatigue (follow up: 9 months; assessed with: FACIT-F (Higher values – > benefit) (MCID 15.9)
Importance: IMPORTANT

Evidence assessment:
GRADE: Risk of bias: result: SERIOUS
rationales: Downgraded by one level due to serious risk of bias. Lack of allocation concealment, incomplete outcome data and selective reporting.
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: NOT_SERIOUS
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: MODERATE
No of participants: Taper off DMARDs: 63
Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD): 65
Effect: Relative Effect (95% CI): -
Absolute Effect (95% CI): MD 1.8 higher (1.25 lower to 4.85 higher)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with RA on DMARDs who are in remission gradually taper off DMARDs, Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD), or continue DMARDS at the same doses?
Population: Patients with RA on DMARDs in remission
Intervention: Taper off DMARDs (as long as the patient remains on at least one DMARD)
Comparator: Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD)
Outcome: Withdrawal due to adverse events (follow up: 9 months)
Importance: IMPORTANT

Evidence assessment:
GRADE: Risk of bias: result: SERIOUS
rationales: Downgraded by one level due to serious risk of bias. Lack of allocation concealment, incomplete outcome data and selective reporting.
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: VERY_SERIOUS
rationales: Downgraded by two levels due to very serious imprecision. Very low number of events.
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: VERY LOW
No of participants: Taper off DMARDs: 3/63 (4.8%)
Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD): 0/65 (0.0%)
Effect: Relative Effect (95% CI): RR 7.22 (0.38 to 136.98)
Absolute Effect (95% CI): 0 fewer per 1,000 (from 0 fewer to 0 fewer)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with RA on DMARDs who are in remission gradually taper off DMARDs, Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD), or continue DMARDS at the same doses?
Population: Patients with RA on DMARDs in remission
Intervention: Taper off DMARDs (as long as the patient remains on at least one DMARD)
Comparator: Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD)
Outcome: Serious adverse events (follow up: 9 months)
Importance: IMPORTANT

Evidence assessment:
GRADE: Risk of bias: result: SERIOUS
rationales: Downgraded by one level due to serious risk of bias. Lack of allocation concealment, incomplete outcome data and selective reporting.
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: VERY_SERIOUS
rationales: Downgraded by two levels due to very serious imprecision. Very low number of events.
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: VERY LOW
No of participants: Taper off DMARDs: 3/63 (4.8%)
Abruptly withdraw DMARDs (as long as the patient remains on at least one DMARD): 2/65 (3.1%)
Effect: Relative Effect (95% CI): RR 1.55 (0.27 to 8.95)
Absolute Effect (95% CI): 17 more per 1,000 (from 22 fewer to 245 more)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with RA on two or more DMARDs who are at target for less than six months withdraw DMARDs or continue DMARDs?
Population: Patients with RA on two or more DMARDs at target for less than six months
Intervention: Withdraw one DMARD (or more than one DMARD as long as the patient remains on at least one DMARD)
Comparator: Continue current therapy
Outcome: Disease activity (follow up: 1 year; assessed with: DAS28-ESR (Lower values – > benefit) (MCID -1.17)
Importance: CRITICAL

Evidence assessment:
GRADE: Risk of bias: result: NOT_SERIOUS
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: NOT_SERIOUS
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: HIGH
No of participants: Withdraw one DMARD: 398
Continue current therapy: 201
Effect: Relative Effect (95% CI): -
Absolute Effect (95% CI): MD 0.59 higher (0.4 higher to 0.78 higher)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with RA on two or more DMARDs who are at target for less than six months withdraw DMARDs or continue DMARDs?
Population: Patients with RA on two or more DMARDs at target for less than six months
Intervention: Withdraw one DMARD (or more than one DMARD as long as the patient remains on at least one DMARD)
Comparator: Continue current therapy
Outcome: Remission (follow up: 1 year; assessed with: DAS28-ESR <2.6)
Importance: CRITICAL

Evidence assessment:
GRADE: Risk of bias: result: NOT_SERIOUS
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: NOT_SERIOUS
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: HIGH
No of participants: Withdraw one DMARD: 179/398 (45.0%)
Continue current therapy: 134/201 (66.7%) 
Effect: Relative Effect (95% CI): RR 0.67 (0.58 to 0.78)
Absolute Effect (95% CI): 220 fewer per 1,000 (from 280 fewer to 147 fewer)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with RA on two or more DMARDs who are at target for less than six months withdraw DMARDs or continue DMARDs?
Population: Patients with RA on two or more DMARDs at target for less than six months
Intervention: Withdraw one DMARD (or more than one DMARD as long as the patient remains on at least one DMARD)
Comparator: Continue current therapy
Outcome: Flare (follow up: range 7 months to 12 months)
Importance: CRITICAL

Evidence assessment:
GRADE: Risk of bias: result: SERIOUS
rationales: A study contributing 27% of the weight is at very serious risk of bias, while the other study is at risk of bias due to the lack of blinding of participants and personnel.
Inconsistency: result: NOT_SERIOUS
rationales: I2=57%
Indirectness: result: NOT_SERIOUS
Imprecision: result: NOT_SERIOUS
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: MODERATE
No of participants: Withdraw one DMARD: 100/136 (73.5%)  
Continue current therapy: 24/75 (32.0%) 
Effect: Relative Effect (95% CI): RR 2.40 (1.68 to 3.42)
Absolute Effect (95% CI): 448 more per 1,000 (from 218 more to 774 more)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with RA on two or more DMARDs who are at target for less than six months withdraw DMARDs or continue DMARDs?
Population: Patients with RA on two or more DMARDs at target for less than six months
Intervention: Withdraw one DMARD (or more than one DMARD as long as the patient remains on at least one DMARD)
Comparator: Continue current therapy
Outcome: Radiographic progression (follow up: 1 year; assessed with: mTSS (Lower values – > benefit) (MCID 4.6)
Importance: IMPORTANT

Evidence assessment:
GRADE: Risk of bias: result: NOT_SERIOUS
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: VERY_SERIOUS
rationales: CI interval includes both values suggesting benefit and values suggesting harm
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: LOW
No of participants: Withdraw one DMARD: 351  
Continue current therapy: 184 
Effect: Relative Effect (95% CI): -
Absolute Effect (95% CI): MD 1.77 lower (11.99 lower to 8.45 higher)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with RA on two or more DMARDs who are at target for less than six months withdraw DMARDs or continue DMARDs?
Population: Patients with RA on two or more DMARDs at target for less than six months
Intervention: Withdraw one DMARD (or more than one DMARD as long as the patient remains on at least one DMARD)
Comparator: Continue current therapy
Outcome: Fatigue (follow up: 1 year; assessed with: FACIT-F (Higher values – > benefit) (MCID 15.9)
Importance: IMPORTANT

Evidence assessment:
GRADE: Risk of bias: result: NOT_SERIOUS
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: NOT_SERIOUS
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: HIGH
No of participants: Withdraw one DMARD: 398  
Continue current therapy: 201  
Effect: Relative Effect (95% CI): -
Absolute Effect (95% CI): MD 1.98 lower (3.57 lower to 0.39 lower)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio