Treatment Options for Rheumatoid Arthritis After Initial Anti-TNF Therapy Has Failed

Biologics that work via a different mechanism might be a better choice than a second anti–tumor necrosis factor agent.

At least a third of patients with rheumatoid arthritis (RA) have inadequate responses or adverse reactions to therapy with anti–tumor necrosis factor (TNF) agents. Little guidance exists on which biologic to choose next for such patients. In this study, researchers randomized 300 patients with RA and inadequate responses to initial anti-TNF therapy to receive either a second anti-TNF agent or another biologic with a different mechanism of action (abatacept [Orencia], rituximab [Rituxan], or tocilizumab [Actemra]), chosen by the treating clinician.

At 24 weeks, 69% of patients who received non-TNF biologics achieved good or moderate responses, compared with 52% of patients who received second anti-TNF agents — a significant difference. Respon…

Reviewing Author

Jonathan S. Coblyn, MD

Disclosures

Consultant / Advisory BoardCVS Health

Editorial BoardsUpToDate

Jonathan S. Coblyn, MD

Disclosures

Consultant / Advisory BoardCVS Health

Editorial BoardsUpToDate

Treatment Options for Rheumatoid Arthritis After Initial Anti-TNF Therapy Has Failed

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Reviewing Author