Switching TNF-alpha antagonists in rheumatoid arthritis: The experience of the LORHEN registry

Roberto Caporali, Piercarlo Sarzi-Puttini, Fabiola Atzeni, Roberto Gorla, Matteo Filippini, Antonio Marchesoni, Ennio Giulio Favalli, Francesca Bobbio-Pallavicini, Carlomaurizio Montecucco

Research output: Contribution to journalArticlepeer-review


New biologic agents have changed the paradigm of rheumatoid arthritis treatment, leading to improvement in managing patients' refractory to classical DMARDs. Anti-TNF-alpha is used as first-line treatment in patients failing to respond to classical DMARDs. However, up to 50% of patients fail to respond to these drugs or develop adverse events leading to treatment discontinuation: in these cases the optimal treatment strategy is still a matter of debate even if trying with a second anti-TNF-alpha is considered a good option. We report data of patients switching from a first to a second anti-TNF-alpha from an Italian registry of patients with rheumatoid arthritis, showing that switching is valuable in patients stopping a first anti-TNFα drug. The patients with higher disease activity levels and those stopping the first anti-TNFα treatment because of a lack of efficacy are very likely to respond to the second treatment.

Original languageEnglish
Pages (from-to)465-469
Number of pages5
JournalAutoimmunity Reviews
Issue number6
Publication statusPublished - Apr 2010


  • Anti-TNF-alpha
  • DMARDs
  • Methotrexate
  • Rheumatoid arthritis

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy


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