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One-third of patients with rheumatoid arthritis (RA) do not have an adequate response to tumour necrosis factor (TNF) inhibitors, but there is little guidance available on which treatment to try next.
In a study published in JAMA
[1]
(online, 20 September 2016), researchers assigned 300 patients with persistent RA who had not responded to anti-TNF therapy to another anti-TNF or a non-TNF biologic for 52 weeks.
After 24 weeks, patients in the non-TNF group were twice as likely to have a good or moderate response according to European League Against Rheumatism criteria than those in second-TNF group (69% versus 52%); this difference was maintained at the end of the study.
The authors conclude that although a second anti-TNF is often effective in patients with an insufficient response to a first anti-TNF, a response is more likely with a non-TNF biologic.
References
[1] Gottenberg J-E, Brocq O, Perdriger A et al. Non-TNF-targeted biologic versus a second anti-TNF drug to treat rheumatoid arthritis in patients with insufficient response to a first anti-TNF drug. JAMA 2016;316(11):1172–1180. doi: 10.1001/jama.2016.13512
