ReviewClinical rheumatology2019
Defining response to TNF-inhibitors in rheumatoid arthritis: the negative impact of anti-TNF cycling and the need for a personalized medicine approach to identify primary non-responders.
Review in Clinical rheumatology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 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
32 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Therapeutic efficacy of celastrol in experimental polyarthritis: insights from a meta-analysis of in vivo studies.Inflammopharmacology · 2025Pooled it
- Janus Kinase Inhibitors Improve Disease Activity and Patient-Reported Outcomes in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis of 24,135 Patients.International journal of molecular sciences · 2022Pooled it
- Olokizumab, a monoclonal antibody against interleukin-6, in combination with methotrexate in patients with rheumatoid arthritis inadequately controlled by tumour necrosis factor inhibitor therapy: efficacy and safety results of a randomised controlled phase III study.Annals of the rheumatic diseases · 2022Trial
- Long-term Comparative Adherence and Switch Rates in Patients Receiving Advanced Therapies for Rheumatoid Arthritis After Use of One TNF Inhibitor.Rheumatology and therapy · 2026Article
- Real-World Analysis of Initial Clinical Response and Future Outcomes Among Patients with Rheumatoid Arthritis Initiating and Remaining on a First-Line Tumor Necrosis Factor Inhibitor in the United States.Rheumatology and therapy · 2026Article
- Molecular cytokine-dependent mechanisms of periodontitis pathogenesis and the potential for pharmacological IL-1 modulation in disease treatment.Frontiers in dental medicine · 2026Review
- Real-World Persistence and Effectiveness of Upadacitinib versus Other Janus Kinase Inhibitors and Tumor Necrosis Factor Inhibitors in Australian Patients with Rheumatoid Arthritis.Rheumatology and therapy · 2025Article
- Pharmacogenomic landscape of TNF inhibitors in the Middle Eastern Qatari population.Frontiers in immunology · 2025Article
- Primary non-response in inflammatory arthritis treated with biologics and targeted therapies in daily clinical practice.Therapeutic advances in musculoskeletal disease · 2025Article
- Comparative Study of Adalimumab, Infliximab and Certolizumab Pegol in the Treatment of Cystoid Macular Edema Due to Behçet's Disease.Journal of clinical medicine · 2024Article
- Small intestinal derived Prevotella histicola simulates biologic as a therapeutic agent.Scientific reports · 2024Article
- Targeting TNF/TNFR superfamilies in immune-mediated inflammatory diseases.The Journal of experimental medicine · 2024Review
- Article
- Decision Impact Analysis to Measure the Influence of Molecular Signature Response Classifier Testing on Treatment Selection in Rheumatoid Arthritis.Rheumatology and therapy · 2024Article
- Harnessing Variability Signatures and Biological Noise May Enhance Immunotherapies' Efficacy and Act as Novel Biomarkers for Diagnosing and Monitoring Immune-Associated Disorders.ImmunoTargets and therapy · 2024Article
- Non-trough adalimumab and certolizumab drug levels associated with a therapeutic EULAR response in adherent patients with rheumatoid arthritis.Rheumatology (Oxford, England) · 2023Observational
- Continuity of Care Within a Single Patient Support Program for Patients with Rheumatoid Arthritis Prescribed Second or Later Line Advanced Therapy.Advances in therapy · 2023Article
- Leveraging the tolerogenic potential of TNF-α and regulatory B cells in organ transplantation.Frontiers in immunology · 2023Review
- Psychological tendencies of children with juvenile idiopathic arthritis.Scandinavian journal of psychology · 2022Article
- IL-10 Induced by mTNF Crosslinking-Mediated Reverse Signaling in a Whole Blood Assay Is Predictive of Response to TNFi Therapy in Rheumatoid Arthritis.Journal of personalized medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Current guidelines recommend treating rheumatoid arthritis (RA) patients to reach low disease activity or remission, however, most biologic-naive RA patients fail to reach treatment targets on their first biologic therapy. Approximately 90% of biologic-naive RA patients receive a tumor necrosis factor alpha inhibitor (anti-TNF) as their first biologic treatment, even though several alternative mechanism of action (MOA) therapies are approved as first-line options. After 3 months of therapy, patients may remain on anti-TNF therapy even if they fail to achieve the treatment target, mainly due to formulary structures. This means patients have to endure a second and even a third ineffective anti-TNF-called anti-TNF cycling-before changing MOA. This significantly delays patients from reaching their treatment targets. All anti-TNF drugs target the same molecular and inflammatory pathways; thus, it is not surprising that most patients who are primary non-responders to their initial anti-TNF therapy fail to achieve their treatment targets when cycled through alternative anti-TNFs. This suggests that primary non-responders should be switched to an alternative MOA therapy rather than enduring anti-TNF cycling. Avoiding anti-TNF cycling would prevent disease progression and improve quality of life for RA patients who are primary non-responders to anti-TNFs. The development of a personalized medicine approach to identify primary non-responders to anti-TNFs prior to treatment would allow significantly more patients to reach their treatment target by treating them with alternative MOA therapies as first-line therapies.
Indexed as
Identifiers
31520227What OpenQuestion holds
Registered trials
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.