Cycling Within TNF Inhibitors: Complications and Factors Influencing Treatment Choices

Opinion
Video

Panelists discuss how continued cycling of tumor necrosis factor inhibitors (TNFis) without achieving remission can lead to complications like irreversible joint erosion, significantly diminishing patient quality of life, and explore why providers may persist with TNFis despite failure, access barriers to switching mechanisms of action, and treatment considerations for patients whose initial positive response to TNFis declines over time.

Video content above is prompted by the following:

  • If a patient continues to cycle tumor necrosis factor inhibitors (TNFis) and does not achieve remission, how do complications, such as irreversible joint erosion, potentially affect patient quality of life?
  • With the wide range of treatment options, why do you think providers are continuing to choose a second or even a third TNFi after the first fails?
  • Are there access barriers to switching mechanism of action (MOA)? What are other barriers to care exist when switching to another MOA vs cycling a TNF?
  • What treatment considerations do you give to a patient who initially responds well to a TNFi but the response wanes over time?
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