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Table 4 Switching between TNF and non-TNF biologic DMARDs

From: Factors associated with initial or subsequent choice of biologic disease-modifying antirheumatic drugs for treatment of rheumatoid arthritis

Prior biologic Number (% of all prior biologic DMARDs) Number of switches (% of each prior biologic DMARD) Adjusteda OR of any switch (95% CI) Switch to TNF or to non-TNF inhibitorsb
Number of switches to TNF inhibitors (%) Number of switches to non-TNF inhibitors (%)
TNF inhibitors
 Etanercept 11,753 (50.6) 1223 (10.4) Reference 989 (80.9) 234 (19.1)
 Adalimumab 5119 (22.0) 732 (14.3) 1.22 (1.10, 1.35) 573 (78.3) 159 (21.7)
 Certolizumab 104 (0.4) 20 (19.2) 1.44 (0.86, 2.39) 8 (40.0) 12 (60.0)
 Golimumab 130 (0.6) 35 (26.9) 2.24 (1.48, 3.37) 22 (62.9) 13 (37.1)
 Infliximab 5102 (22.0) 567 (11.1) 1.06 (0.95, 1.19) 377 (66.5) 190 (33.5)
Non-TNF inhibitor biologic agents
 Abatacept 407 (1.8) 70 (17.2) 1.31 (0.99, 1.72) 40 (57.1) 30 (42.9)
 Anakinra 260 (1.1) 85 (32.7) 3.20 (2.41, 4.25) 79 (92.9) 6 (7.1)
 Rituximab 334 (1.4) 27 (8.1) 0.57 (0.38, 0.85) 16 (59.3) 11 (40.7)
 Tocilizumab 22 (0.1) 2 (9.1) 0.59 (0.14, 2.60) 0 (0.0) 2 (100)
Total 23231 (100) 2761 (11.9) 743 (76.2) 657 (23.8)
  1. DMARD disease-modifying antirheumatic drug. aAdjusted for demographics, data source, calendar year, comorbidities, history of medication use, and healthcare utilization in the baseline period. bTNF inhibitors include adalimumab, certolizumab, etanercept, golimumab, and infliximab; non-TNF inhibitors include abatacept, anakinra, rituximab, and tocilizumab