Ankylosing Spondylitis Treatment after First Anti-TNF Drug Failure

Although anti-tumor necrosis factor (TNF) therapy has revo-lutionised the management of spondyloarthritis (SpA), 20–30% of SpA patients discontinue biological treatment because they fail to respond or their response is inadequate, and 10–20% stop because of a lack or loss of efficacy or the onset of adverse events. Published data show that anti-TNF drugs in are highly effective in patients with ankylosing spondylitis, and associated with a higher drug persistence rate. Furthermore, studies suggest considering a switch to another anti-TNF drug if a first anti-TNF agent is discontinued because of loss of efficacy or adverse events.