Response to: 'Correspondence on 'Tapering towards DMARD-free remission in rheumatoid arthritis' by Garcia et al.

We appreciate the interest of Garcia and Abud-Mendoza in our article on tapering towards disease-modifying antirheumatic drug (DMARD)-free remission (DFR), and we would like to respond to the points that were brought up.1 2 Garcia and Abud-Mendoza1 proposed two ways to reduce the amount of flares during tapering of medication, namely (1) the (continuous) use of low-dose glucocorticoids (GCs) and (2) the use of ultrasound to detect subclinical synovitis before a flare occurs. Although the (continuous) use of low-dose GCs might help in tapering DMARDs, including biologicals, to lower dosages without experiencing a flare, it does not alter the DFR rates because, in our opinion, patients are only in DFR if they do not use any DMARD, including GCs. However, we believe that DFR is not a suitable treatment goal because only 15% of patients with rheumatoid arthritis (RA) …