Discontinuation of Disease-modifying Anti-rheumatic Drugs (DMARDs) in Rheumatoid Arthritis Patients Also Using TNF Inhibitors

Inclusion Criteria: * Age ≥ 18 years. * Diagnosis of RA, according to the 2010 ACR/EULAR and/or 1987 RA classification criteria or clinical diagnosis by a rheumatologist. * Stable disease activity for ≥ 6 months, defined as DAS28-CRP ≤ 2.9 or DAS28-CRP ≤ 3.5 combined with clinical judgment of LDA. * Current combination therapy consisting of TNFi and either MTX or LEF. * TNFi administration at a stable dose (at an optimal dose, defined as the authorized dose or lower and being maximally tapered, because of prior disease flare or patient preference) for ≥6 months prior to screening, during which LDA is maintained for ≥6 months. * MTX or LEF administration at a stable dose for ≥3 months prior to screening. * Ability to comply with all study procedures, visits and follow-up assessments. * Written informed consent provided prior to any study-related procedure. Exclusion Criteria: * A previous attempt within the last 12 months prior to screening to taper or discontinue MTX or LEF that required reintroduction or dose increase of the csDMARD due to a disease flare. * Current MTX or LEF treatment for other indications than RA. * Current treatment with prednisolone (equivalent) of \> 5 mg per day. * Current severe comorbidity or serious life-shortening condition that could interfere with adherence to the study protocol or completion of the 24-month follow-up period. * Women that are pregnant, breast feeding or considering pregnancy during the study period (MTX and LEF are contraindicated in pregnancy and breastfeeding). * Inability to comply with the study procedures, visits, or follow-up assessments. * Inability or unwillingness to provide informed consent.