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What to do when the first TNF inhibitor fails in rheumatoid arthritis: stratified expert recommendations from a scoping review and Delphi consensus

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Therapeutic Advances in Musculoskeletal Disease

Published online on

Abstract

Therapeutic Advances in Musculoskeletal Disease, Volume 18, January-December 2026.
Background:Despite widespread use of tumor necrosis factor inhibitors (TNFi) as first-line therapy in rheumatoid arthritis (RA), up to 40% of patients fail initial treatment. Subsequent therapeutic choices remain poorly structured, with limited evidence-...