{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T02:34:47Z","timestamp":1789698887308,"version":"4.0.1"},"reference-count":52,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T00:00:00Z","timestamp":1743292800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T00:00:00Z","timestamp":1743292800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Instituto de Salud Carlos III (ISCIII), Ministry of Health, Spain","award":["PI23\/00343"],"award-info":[{"award-number":["PI23\/00343"]}]},{"DOI":"10.13039\/501100008530","name":"Fondo Europeo de Desarrollo Regional","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Musculoskeletal"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Switching between therapies is a recommended strategy for rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients who experience treatment failure; moreover, data on switching due to primary non-response and subsequent failures are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To obtain information from clinical practice regarding failures due to primary non-response in patients on biologic and target synthetic disease-modifying antirheumatic drugs (ts\/bDMARDs), assessing the incidence rate (IR) of switching due to primary non-response and risk of subsequent treatment failure by cycling compared to swapping.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A longitudinal retrospective study, spanning from 2007 to 2022, was conducted on patients with RA or PsA treated with ts\/bDMARDs at an outpatient rheumatology clinic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The main outcomes were as follows: (1) ts\/bDMARD failure due to primary non-response and (2) subsequent discontinuation of prescribed ts\/bDMARD due to lack of efficacy. The independent variable was switching between classes compared to switching within class. As covariates, clinical, sociodemographic, clinical, and treatments were considered. To estimate ts\/bDMARDs switching rates, survival techniques were used, expressing the IR per 100 patients\u2009*\u2009year with their 95% confidence interval. Cox multivariate regression analyses were run to assess the role of switching between\/within class in the subsequent treatment failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In total, 327 patients were included. Of these, 50 patients in 77 treatment courses developed primary non-response with an IR of 4.25 (3.4\u20135.3). The IR was quite similar between RA and PsA, higher in women, and in those who started ts\/bDMARDs after 2018. In those with primary non-response, there were 42 subsequent treatment failures with an IR of 26.38 (19.49\u201335.69). The multivariate model showed that cycling increased the risk of subsequent failure compared to swapping (hazard ratio: 2 (1.1\u20133.77),\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This study provides support to consider swapping a better alternative rather than cycling after primary non-response.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1759720x251325665","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T01:14:31Z","timestamp":1743383671000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Primary non-response in inflammatory arthritis treated with biologics and targeted therapies in daily clinical practice"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7142-0545","authenticated-orcid":false,"given":"Leticia","family":"Leon","sequence":"first","affiliation":[{"name":"Musculoskeletal Pathology Group, Rheumatology Department, IdISSC, Hospital Cl\u00ednico San Carlos, c\\Prof, Mart\u00edn Lagos s\/n, Madrid 28040, Spain"},{"name":"Faculty of Health Sciences\u2014HM Hospitals, University Camilo Jos\u00e9 Cela, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalifer","family":"Freites-Nu\u00f1ez","sequence":"additional","affiliation":[{"name":"Rheumatology Department and IdISSC, Hospital Cl\u00ednico San Carlos, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Toledano","sequence":"additional","affiliation":[{"name":"Rheumatology Department and IdISSC, Hospital Cl\u00ednico San Carlos, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Candelas","sequence":"additional","affiliation":[{"name":"Rheumatology Department and IdISSC, Hospital Cl\u00ednico San Carlos, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Martinez","sequence":"additional","affiliation":[{"name":"Rheumatology Department and IdISSC, Hospital Cl\u00ednico San Carlos, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Rodr\u00edguez-Laguna","sequence":"additional","affiliation":[{"name":"Rheumatology Department and IdISSC, Hospital Cl\u00ednico San Carlos, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6126-8786","authenticated-orcid":false,"given":"Benjam\u00edn","family":"Fern\u00e1ndez-Guti\u00e9rrez","sequence":"additional","affiliation":[{"name":"Rheumatology Department and IdISSC, Hospital Cl\u00ednico San Carlos, Madrid, Spain Medicine Department, Universidad Complutense de Madrid, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8152-0478","authenticated-orcid":false,"given":"Lydia","family":"Abasolo","sequence":"additional","affiliation":[{"name":"Musculoskeletal Pathology Group, Rheumatology Department, IdISSC, Hospital Cl\u00ednico San Carlos, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,3,30]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2020.10.010"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2018.1"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.13103"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.1049875"},{"key":"e_1_3_4_6_2","article-title":"Treatment guidelines in psoriatic arthritis","volume":"59","author":"Ogdie A","year":"2021","unstructured":"Ogdie A, Coates LC, Gladman DD. 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