{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T18:46:46Z","timestamp":1777661206083,"version":"3.51.4"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,8,21]],"date-time":"2020-08-21T00:00:00Z","timestamp":1597968000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,8,21]],"date-time":"2020-08-21T00:00:00Z","timestamp":1597968000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100009947","name":"Merck Sharp and Dohme","doi-asserted-by":"publisher","award":["IIS# 57763"],"award-info":[{"award-number":["IIS# 57763"]}],"id":[{"id":"10.13039\/100009947","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","award":["SFRH\/BD\/108246\/2015"],"award-info":[{"award-number":["SFRH\/BD\/108246\/2015"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arthritis Res Ther"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To investigate whether the reason to discontinue the first TNF inhibitor (TNFi) affects the response to the second TNFi in axial spondyloarthritis (axSpA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with axSpA from the Rheumatic Diseases Portuguese Register (ReumaPt), who discontinued their first TNFi and started the second TNFi between June 2008 and May 2018, were included. Response was assessed by the Ankylosing Spondylitis Disease Activity Score (ASDAS) clinically important improvement (ASDAS-CII), major important improvement (ASDAS-MI), low disease activity (ASDAS-LDA), and inactive disease (ASDAS-ID). The reason for discontinuation of the first TNFi was defined, according to ASDAS-CII as primary failure (no response \u2264\u20096\u2009months), secondary failure (response \u2264\u20096\u2009months but lost thereafter), adverse events, and others. The association between the reason for discontinuation of the first TNFi and response to the second TNFi over time was assessed in multivariable generalized equation (GEE) models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 193 patients were included. The reason for discontinuation of the first TNFi did not influence the response to the second TNFi, according to the ASDAS-CII. However, a difference was found with more stringent outcomes, e.g., there was a higher likelihood to achieve ASDAS-ID with the second TNFi for patients discontinuing the first TNFi due to secondary failure (OR 7.3 [95%CI 1.9; 27.7]), adverse events (OR 9.1 [2.5; 33.3]), or other reasons (OR 7.7 [1.6; 37.9]) compared to primary failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with axSpA with secondary failure to their first TNFi, compared to those with primary failure, have a better response to the second TNFi according to stringent outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13075-020-02288-8","type":"journal-article","created":{"date-parts":[[2020,8,21]],"date-time":"2020-08-21T01:19:34Z","timestamp":1597972774000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Effectiveness of switching between TNF inhibitors in patients with axial spondyloarthritis: is the reason to switch relevant?"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7217-0469","authenticated-orcid":false,"given":"Santiago Rodrigues","family":"Manica","sequence":"first","affiliation":[]},{"given":"Alexandre","family":"Sepriano","sequence":"additional","affiliation":[]},{"given":"Fernando","family":"Pimentel-Santos","sequence":"additional","affiliation":[]},{"given":"N\u00e9lia","family":"Gouveia","sequence":"additional","affiliation":[]},{"given":"Anabela","family":"Barcelos","sequence":"additional","affiliation":[]},{"given":"Jaime C.","family":"Branco","sequence":"additional","affiliation":[]},{"given":"Miguel","family":"Bernardes","sequence":"additional","affiliation":[]},{"given":"Raquel Miriam","family":"Ferreira","sequence":"additional","affiliation":[]},{"given":"Elsa","family":"Vieira-Sousa","sequence":"additional","affiliation":[]},{"given":"Sofia","family":"Barreira","sequence":"additional","affiliation":[]},{"given":"Filipe","family":"Vinagre","sequence":"additional","affiliation":[]},{"given":"Raquel","family":"Roque","sequence":"additional","affiliation":[]},{"given":"Helena","family":"Santos","sequence":"additional","affiliation":[]},{"given":"Nathalie","family":"Madeira","sequence":"additional","affiliation":[]},{"given":"Jo\u00e3o","family":"Rovisco","sequence":"additional","affiliation":[]},{"given":"Alexandra","family":"Daniel","sequence":"additional","affiliation":[]},{"given":"Sofia","family":"Ramiro","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2020,8,21]]},"reference":[{"key":"2288_CR1","unstructured":"George MD, Baker JF, Ogdie A. Comparative persistence on methotrexate and TNF inhibitors in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. J Rheumatol. 2019;47(8):1499\u20132752. https:\/\/www.jrheum.org\/content\/early\/2019\/08\/25\/jrheum.190299."},{"key":"2288_CR2","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1186\/s13075-016-0969-2","volume":"18","author":"A Ciurea","year":"2016","unstructured":"Ciurea A, Exer P, Weber U, Tamborrini G, Steininger B, Kissling RO, et al. Does the reason for discontinuation of a first TNF inhibitor influence the effectiveness of a second TNF inhibitor in axial spondyloarthritis? Results from the Swiss Clinical Quality Management Cohort. 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This specific study has been approved by the ethics committee of the NOVA Medical School, Lisbon, Portugal. Patients have signed a written informed consent before inclusion.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"SRM: honoraria as a speaker\u2014Janssen, NovartisAS: honoraria as a speaker\u2014NovartisSR: consulting and\/or speaking fees\u2014AbbVie, Eli Lilly, MSD, Novartis, Pfizer, Sanofi, and UCBAB: consulting and\/or speaking fees\u2014AbbVie, Eli Lilly, MSD, Novartis, and Pfizer","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"195"}}