Switching between TNFα antagonists in rheumatoid arthritis: personal experience and review of the literature* Passaggio ad altro antagonista del TNFα in pazienti con artrite reumatoide: esperienza personale e review della letteratura

The treatment of rheumatoid arthritis (RA) has evolved over the past decade with the introduction of anti-tumor necrosis factor (TNF) α agents, which allowed remarkable advances in controlling signs and symptoms of inflammation and in slowing joint destruction (1-3). However, some patients do not respond or show suboptimal response to the currently available anti- TNFα agents (infliximab, etanercept, and adalimumab) used either as monotherapy or in combination with methotrexate. Furthermore, patients who respond initially may lose efficacy over time (4) or develop adverse events.