Comparison of the efficacy and risk of discontinuation between non-TNF-targeted treatment and a second TNF inhibitor in patients with rheumatoid arthritis after first TNF inhibitor failure.

Moreover, real-world data from the United States showed that during a median follow-up of 29.9 months, TNFi cyclers were more likely to be non-persistent (HR = 1.511, 95% CI: 1.196–1.908, p = 0.001) than new non-TNFi switchers, and switching to a non-TNF-targeted treatment (abatacept, anakinra, rituximab, tocilizumab or tofacitinib) showed a trend toward greater disease activity reduction. 27 A recent US study of large-scale claim-based data also found that, although the treatment cost tended to be lower for TNFi cycling, patients who swapped to a non-TNF-targeted treatment (abatacept, anakinra, rituximab, tocilizumab, or tofacitinib) ha

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