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To switch or to change class—the biologic dilemma in rheumatoid arthritis

Nature Reviews Rheumatology volume 6, pages 301–305 (2010)Cite this article

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Abstract

The management of rheumatoid arthritis has greatly improved in the past decade, owing to new treatment strategies and the introduction of agents that inhibit tumor necrosis factor (TNF). Unfortunately, a substantial proportion of patients will discontinue therapy with their first TNF inhibitor for various reasons (for example, non-response, loss of efficacy, or toxicity). Until recently, treatment options for these patients were limited and most rheumatologists chose to switch to treatment with an alternative TNF inhibitor. However, biologic agents with different modes of action have now become available. Hence, the dilemma now facing rheumatologists presented with patients who fail to respond to anti-TNF therapy is whether to switch to an alternative TNF inhibitor or to change to a biologic agent of a different drug class. This article discusses the evidence relating to these two options.

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Authors and Affiliations

  1. Section of Musculoskeletal Diseases, Leeds Institute of Molecular Medicine, University of Leeds, 2nd Floor Chapel Allerton Hospital, Chapeltown Road, LS7 4SA, Leeds, UK

    Edith Villeneuve

  2. Institut de Rhumatologie de Montral, 1551 Rue Ontario Est, Montreal, H2L 1S6, QC, Canada

    Boulos Haraoui

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  1. Edith Villeneuve
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Correspondence to Boulos Haraoui.

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Competing interests

B. Haraoui has acted as a consultant for and received grants or research support from Abbott, Amgen, Bristol-Myers Squibb, Roche, Schering and Wyeth. E. Villeneuve declares no competing interests.

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Villeneuve, E., Haraoui, B. To switch or to change class—the biologic dilemma in rheumatoid arthritis. Nat Rev Rheumatol 6, 301–305 (2010). https://doi.org/10.1038/nrrheum.2010.45

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