类风湿性关节炎（RA）是一种慢性自身免疫性疾病，严重影响患者的生活质量。尽管多年来治疗选择不断增加，包括引入肿瘤坏死因子-α (TNFα) 抑制剂 (TNFi)，但优化这些药物的停药策略仍然是一个挑战。本综述探讨了 RA 中 TNFi 停药策略的当前证据，重点关注影响退出决定的因素，如疾病活动监测、治疗反应、患者特征和生物标志物。我们进行了全面的文献检索，包括随机对照试验、观察性研究和专家指南。讨论了 RA 的病理生理学、当前的药物制剂和目标治疗策略，以提供对 RA 管理的整体理解。停药策略可能适合某些患者，请记住，有几个因素会影响停药决定，包括治疗反应、疾病活动和监测以及患者特征。撤回 TNFi 的决定必须权衡益处与疾病发作的潜在风险和长期治疗相关的不良反应。早期结合 DMARD 和 TNFi 可改善结果，支持成本效益和预防耀斑的逐渐减少策略。提出了未来的方向，包括精准医疗方法、以患者为中心的护理模式和健康经济学分析，以进一步优化 RA 管理并改善患者治疗结果。

Rheumatoid arthritis (RA) is a chronic autoimmune disease that significantly impacts patients' quality of life. While treatment options have expanded over the years, including the introduction of tumor necrosis factor-alpha (TNFα) inhibitors (TNFi), optimizing withdrawal strategies for these agents remains a challenge.This review examines the current evidence on TNFi withdrawal strategies in RA, focusing on factors influencing withdrawal decisions such as disease activity monitoring, treatment response, patient characteristics, and biomarkers. A comprehensive literature search was conducted, including randomized controlled trials, observational studies, and expert guidelines. The pathophysiology of RA, current pharmacological agents, and the treat-to-target strategy are discussed to provide a holistic understanding of RA management.Withdrawal strategies could be suitable for certain patients, keeping in mind that several factors influence withdrawal decisions, including treatment response, disease activity and monitoring, and patient characteristics. The decision to withdraw TNFi must balance the benefits against the potential risks of disease flare and long-term treatment-related adverse effects. Combining DMARDs and TNFi early improves outcomes, supporting tapering strategies for cost-effectiveness and flare prevention. Future directions, including precision medicine approaches, patient-centered care models, and health economics analyses, are proposed to further optimize RA management and improve patient outcomes.