ReviewTherapeutic advances in musculoskeletal disease2022
Managing inadequate response to initial anti-TNF therapy in rheumatoid arthritis: optimising treatment outcomes.
Review in Therapeutic advances in musculoskeletal disease, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis 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
35 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.
- From Methotrexate Resistance to Biologic and Targeted Pharmacotherapy: A Decade of Phase 4 Clinical Trials Evidence in Rheumatoid Arthritis.Drug design, development and therapy · 2026Pooled it
- Trial
- Efficacy and Safety of ABBV-154 for the Treatment of Active Rheumatoid Arthritis: A Phase 2b, Randomized, Placebo-Controlled Trial.Arthritis & rheumatology (Hoboken, N.J.) · 2025Trial
- Application of CAR-T cell therapy in orthopedics: From bone malignancies to non-malignant musculoskeletal disorders.Journal of orthopaedic translation · 2026Review
- Cortistatin as a pleiotropic regulator of neuroimmune and inflammatory pathways in experimental disease: a scoping review of preclinical evidence.Inflammopharmacology · 2026Article
- Use of Artificial Intelligence in Rheumatoid Arthritis: Advancements and Novel Perspectives.Journal of clinical medicine · 2026Review
- Review
- Toward causal artificial intelligence for biologic treatment response in rheumatoid arthritis: current evidence and future directions.Rheumatology international · 2026Review
- Advancement of humanized mice and leading applications in immunological disease models.Inflammation and regeneration · 2026Review
- Antinuclear Antibodies Predict Treatment Escalation and Biologic Switching in Rheumatoid Arthritis.Diagnostics (Basel, Switzerland) · 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
- Targeting the synovial engine: next-generation engineered immune cells to eradicate pathogenic FLS in rheumatoid arthritis, with safety-first, selective designs.Frontiers in immunology · 2026Review
- What to do when the first TNF inhibitor fails in rheumatoid arthritis: stratified expert recommendations from a scoping review and Delphi consensus.Therapeutic advances in musculoskeletal disease · 2026Article
- multiDEGGs: Single or Multiomic Differential Network Analysis for Biomarker Discovery and Feature Engineering for Predictive Modeling.Computational and structural biotechnology journal · 2026Article
- Effects of Janus Kinase Inhibitors on Rheumatoid Arthritis Pain: Clinical Evidence and Mechanistic Pathways.Biomedicines · 2025Review
- The impact of alpha-lipoic acid treatment on various mediators of inflammatory and immune responses in a murine arthritis model.Inflammopharmacology · 2025Article
- Incidence and reasons for biologic and targeted synthetic DMARD switching in juvenile idiopathic arthritis: a real- life stratified analysis.Pediatric rheumatology online journal · 2025Article
- Article
- Towards better personalized care in rheumatoid arthritis.Rheumatology (Oxford, England) · 2025Article
- Rheumatoid Factor: Diagnostic and Prognostic Performance and Therapeutic Implications in Rheumatoid Arthritis.Journal of clinical medicine · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 5 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Anti-tumour necrosis factors (anti-TNFs) are established as first-line biological therapy for rheumatoid arthritis (RA) with over two decades of accumulated clinical experience. Anti-TNFs have well established efficacy/safety profiles along with additional benefits on various comorbidities. However, up to 40% of patients may respond inadequately to an initial anti-TNF treatment because of primary non-response, loss of response, or intolerance. Following inadequate response (IR) to anti-TNF treatment, clinicians can consider switching to an alternative anti-TNF (cycling) or to another class of targeted drug with a different mechanism of action, such as Janus kinase inhibitors, interleukin-6 receptor blockers, B-cell depletion agents, and co-stimulation inhibitors (swapping). While European League Against Rheumatism recommendations for pharmacotherapeutic management of RA, published in 2020, are widely regarded as helpful guides to clinical practice, they do not provide any clear recommendations on therapeutic choices following an IR to first-line anti-TNF. This suggests that both cycling and swapping treatment strategies are of equal value, but that the treating physician must take the patient's individual characteristics into account. This article considers which patient characteristics influence clinical decision-making processes, including the reason for treatment failure, previous therapies, comorbidities, extra-articular manifestations, pregnancy, patient preference and cost-effectiveness, and what evidence is available to support decisions made by the physician.
Indexed as
Identifiers
What 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.