About one quarter of patients prescribed a first-line TNF inhibitor for rheumatoid arthritis will switch to another agent within the first 12 months of therapy, Australian researchers have found.

And the most common reason for stopping or changing to another biologic or targeted synthetic disease-modifying antirheumatic drug (DMARD) was lack of efficacy rather than adverse events, their study shows.

The authors also suggest that some biologics including rituximab and tocilizumab have a much lower risk of cessation than others when managing rheumatoid arthritis (RA).

Led by rheumatologist Professor Rachelle Buchbinder from Monash University in Melbourne, the team analysed treatment patterns in more than 2800 adults with RA (median age 57) including the frequency and reasons for switching or stopping DMARDs.