TOward the Lowest Effective DOse of Abatacept or Tocilizumab

Tocilizumab: Roactemra 4-8 mg/kg/month and 162 mg/week Abatacept: Orencia 500-1000 mg/month and 125 mg/week

"The decrease pattern is established on 4 consecutive stages :~IV Abatacept (500-1000 mg/month) and Tocilizumab(4-8 mg/kg/month):~Stage 0 : Perfusion /30 days Stage 1 :Perfusion/45 days Stage 2 :Perfusion/60 days Stage 3 :Perfusion/90 days Stage 4 :Stop~SC Abatacept (125 mg/week) and Tocilizumab (162 mg/week):~Stage 0 :Injection/7 days Stage 1 :Injection/10 days Stage 2 :Injection/14 days Stage 3 :Injection/21 days Stage 4 :Stop~* If DAS 28 ≤ 2,6 (remission DAS persistent) on trimestrial visit: transfer to next stage for 3 months before next evaluation.~* If DAS 28 \> 2,6 et ≤ 3,2 (weak activity) : maintain ongoing stage~* If DAS 28 \> 3,2 : return to previous stage, (relapse according to European expert consensus)~In the case of relapse while the patient is in stage 0, the therapy modification is left to the investigator's free will, but the patient will be followed till the end of the study."