AIM: To investigate whether remission can be sustained for rheumatoid arthritis 
(RA) patients after tapering abatacept (ABT).
METHOD: All patients were naïve to biological disease-modifying anti-rheumatic 
drugs (bDMARDs) and in low or moderate Disease Activity Score of 28 joints with 
C-reactive protein (DAS)28-CRP). ABT was administrated intravenously (IV) or 
subcutaneously (SC) for 36 weeks to patients with RA, who had not previously 
received bDMARDs. As the ABT tapering protocol, ABT was administrated SC at 
125 mg every 2 weeks for 12 weeks in patients with remission. RA disease 
activity was assessed by DAS28-CRP and ultrasonography. Remission was assessed 
by defining it as DAS28-CRP <2.3.
RESULTS: Of the 51 patients, 84.3% were women (mean age 68.7 ± 10.2 years, mean 
disease duration 7.7 ± 10.2 years). Twenty-nine patients achieved remission and 
a power Doppler (PD) score ≤1 at each joint at 36 weeks, followed by tapering 
ABT. Of these patients, 25 sustained DAS28-CRP remission, and DAS28-CRP was not 
significantly elevated (1.62 ± 0.41 to 1.69 ± 0.49) at 48 weeks, but the total 
PD score was significantly elevated (1.52 ± 1.21 to 2.59 ± 2.81 P = 0.049). 
Longer disease duration, higher DAS28-CRP at 24 weeks, and higher total PD score 
at 24 weeks were predictors of an elevated total PD score after tapering ABT 
therapy.
CONCLUSION: These findings suggest that ABT tapering is a promising short-term 
strategy to sustain remission in patients with RA, and ultrasonography is a 
useful tool for monitoring disease activity after tapering ABT.