ArticleRMD open2017
Switching biological disease-modifying antirheumatic drugs in patients with axial spondyloarthritis: results from a systematic literature review.
Article in RMD open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Comparative efficacy and safety of bimekizumab in axial spondyloarthritis: a systematic literature review and network meta-analysis.Rheumatology (Oxford, England) · 2024Pooled it
- Influence of smoking and obesity on treatment response in patients with axial spondyloarthritis: a systematic literature review.Clinical rheumatology · 2021Pooled it
- [Long version on the S3 guidelines for axial spondyloarthritis including Bechterew's disease and early forms, Update 2019 : Evidence-based guidelines of the German Society for Rheumatology (DGRh) and participating medical scientific specialist societies and other organizations].Zeitschrift fur Rheumatologie · 2019Guideline
- Early divergence of treatment response trajectories to adalimumab or its biosimilar in active ankylosing spondylitis: consensus clustering analysis of a randomized controlled trial.Frontiers in immunology · 2026Trial
- Improvement of Functioning and Health With Ixekizumab in the Treatment of Active Nonradiographic Axial Spondyloarthritis in a 52-Week, Randomized, Controlled Trial.Arthritis care & research · 2022Trial
- Traditional Chinese Medicine (TCM) collaborative care involving acupuncture for axial spondyloarthritis: 6-week exploratory results of a pragmatic randomised controlled trial.EULAR rheumatology open · 2026Article
- Cycling to TNFi vs. Switching to IL-17Ai Among Patients with Psoriatic Arthritis and Axial Spondyloarthritis: Real-World CorEvitas PsA/SpA Registry Data.Advances in therapy · 2026Article
- Real-world clinical experience with upadacitinib in a cohort of Italian patients with axial spondyloarthritis.Frontiers in pharmacology · 2026Article
- Persistence of IL-17 and TNF inhibitors following initial TNF inhibitor use in axial spondyloarthritis: a nationwide retrospective cohort study.Therapeutic advances in musculoskeletal disease · 2026Article
- A retrospective, multinational, cross-sectional survey of real-world outcomes for patients with axial spondyloarthritis receiving subcutaneous infliximab.BMC rheumatology · 2025Article
- Which are the clinical characteristics that lead to the decision of primary or secondary usage of TNFi or IL-17i in patients with axial spondyloarthritis?: Real-world evidence from the RABBIT-SpA cohort.EULAR rheumatology open · 2025Article
- Retention rate of TNF inhibitors versus IL-17 inhibitors in ankylosing spondylitis patients with prior biologics experience.Arthritis research & therapy · 2025Article
- Review
- Ixekizumab Treatment Patterns and Health Care Resource Utilization Among Patients with Axial Spondyloarthritis: A Retrospective United States Claims Database Study.Rheumatology and therapy · 2024Article
- The failure of biological treatment in axial spondyloarthritis is linked to the factors related to increased intestinal permeability and dysbiosis: prospective observational cohort study.Rheumatology international · 2024Observational
- Second and third TNF inhibitors in European patients with axial spondyloarthritis: effectiveness and impact of the reason for switching.Rheumatology (Oxford, England) · 2024Article
- Cost Effectiveness of Tofacitinib for the Treatment of Active Ankylosing Spondylitis in Greece.Clinical drug investigation · 2024Article
- Rationale and concerns for using JAK inhibitors in axial spondyloarthritis.Rheumatology advances in practice · 2024Review
- Management of Specific Clinical Profiles in Axial Spondyloarthritis: An Expert's Document Based on a Systematic Literature Review and Extended Delphi Process.Rheumatology and therapy · 2023Article
- The impact of smoking on response to tumor necrosis factor-α inhibitor treatment in patients with ankylosing spondylitis.Turkish journal of medical sciences · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesFirst, to investigate if switching biological disease-modifying antirheumatic drugs (bDMARDs) after the failure to prior bDMARD is efficacious in patients with axial spondyloarthritis (axSpA). Second, to evaluate the influence on this efficacy of (1) the reason to discontinue prior tumour necrosis factor inhibitor (TNFi), (2) changing the type of TNFi and (3) changing the target.
methodsA systematic literature review until January 2017 was performed using Medline, EMBASE and Cochrane databases. Longitudinal studies assessing clinical response after switching bDMARDs in patients with axSpA were analysed.
resultsIn total, 9 studies out of 1862 retrieved citations were included. Overall, the level of evidence was poor. In these studies, all patients received a TNFi as first bDMARD, 1956 patients switched to a second bDMARD (97% TNFi and 3% interleukin-17 inhibitors (IL-17i)) and 170 to a third bDMARD (all TNFi). Clinical response (Bath Ankylosing Spondylitis Disease Activity Index 50) after a second TNFi was achieved by 25%-56% of patients compared with 50%-72% after the first TNFi. Also, 47% of patients switching to IL-17i after a TNFi responded (Assessment of SpondyloArthritis international Society 40) compared with 66% in those who received IL-17i as first line. The response after switching was not influenced by the reason to discontinue, type of prior TNFi or changing the target.
conclusionsIn patients with axSpA, switching to a second bDMARD (a TNFi or IL-17i) after prior TNFi is efficacious. Nevertheless, the clinical response is lower than the observed in patients naive to bDMARD. So far, the reason to discontinue prior bDMARD or the type of bDMARD has not been identified as predictor of response. Published evidence for switching to a third bDMARD is lacking.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.