Choice of therapeutic tactics after failure of the first tumor necrosis factor-α inhibitor

The paper discusses whether the effect of different biological agents (BAs) can be achieved in patients with active rheumatoid arthritis (RA) when they inadequately respond to therapy with tumor necrosis factor-α (TNF-α) inhibitors. It gives data on the efficacy of BAs with another mechanism of action (abatacept, tocilizumab, and rituximab) and on the comparable efficacy of golimumab (GLM) in this group of patients. It is shown that the effect of GLM therapy does not depend on the reasons for discontinuation of a previously used TNF-α inhibitors (inefficacy, adverse events, etc.). It is conclusion that GLM is effective after failure of one or two TNF-α inhibitors.