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Table 1 Gain of a major response by switching between different available biological agents in rheumatoid arthritis

From: ACR70-disease activity score remission achievement from switches between all the available biological agents in rheumatoid arthritis: a systematic review of the literature

  Results
Study Number of patients Switch type ACR20 ACR50 ACR70 DAS44 <1.6 or DAS28 <2.6 ΔDAS P< 0.05 Evidence levela Strengtha
Anti-TNFα blockers
[3] 25 IFX → ETA 64% 23% 5% - - 3b B
[4] 95 IFX → ETA 38% 24% 15% - 6.46 → 4.97 3b B
[5] 28 ETA → IFX 62% 30.7% - 15.4% 5.2 → 4 3b B
[6] 6,610 ETA/IFX → ADA 60% 33% 13% 12% 31% (-1.9 ± 1.4) 2b B
[7] 25 IFX → ADA 75% 50% 33% - 5.6 → 3.2 3b B
Anti-CD20
[8] 311 Anti-TNFα → RTX 51% 27% 12% 9% 15% (ΔDAS > 1.2) 1b A
SR CTLA-4
[10] 391 Anti-TNFα → ABA 50.4% 20.3% 10.2% 10.0% - 1b A
[11] 1,046 Anti-TNFα → ABA - - - 13.0% 56.1% (-2.0) 1b A
Interleukin-6R inhibitor
[12] 499 Anti-TNFα → TOC 50.0% 28.8% 12.4% 30.1% - 1b A
  1. aAccording to the levels of evidence of the Centre for Evidence-Based Medicine (Oxford, UK). ΔDAS P <0.05, significant difference in disease activity score value before and after switching; ABA, abatacept; ACR20, American College of Rheumatology 20% improvement criteria; ACR50, American College of Rheumatology 50% improvement criteria; ACR70, American College of Rheumatology 70% improvement criteria; ADA, adalimumab; anti-TNFα, anti-tumor necrosis factor-alpha; DAS28, disease activity score using 28 joint counts; DAS44, disease activity score using 44 joint counts; ETA, etanercept; IFX, infliximab; RTX, rituximab; TOC, tocilizumab (8 mg/kg group).