Tapering or reduction of therapy in rheumatoid arthritis is of great interest to both patients and physicians. From a practical standpoint, patients ask their physicians about extending the intervals between administration of biologic DMARD therapy due to the costs of the medication or concerns about long-term side effects. A handful of recent studies have provided support for successful reduction of therapy in patients in a state of low disease activity or remission, though other students have shown evidence of persistent synovitis on ultrasound or MRI of patients in low disease activity or remission. Because of the possibility of continued inflammation despite lack of clinical symptoms, predictors of successful discontinuation of therapy are of great interest. This systematic review looked at 34 studies with 5,724 patients; 19 of these identified predictors of successful discontinuation, including low disease activity, better physical function, low inflammatory markers (ESR and CRP), low or negative RF or CCP, and lack of inflammation detected on ultrasound. Though the included studies are heterogeneous and cannot be used at this point as a clinical rule, the systematic review lends support to the idea of “deep remission,” considered to be a state of stable remission of RA symptoms. —Arundathi Jayatilleke, MD