Clinical Edge

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TNFi Monotherapy Remains Feasible for Older Rheumatoid Arthritis Patients

Key clinical point: Use of tumor necrosis factor inhibitors (TNFi) as monotherapy was associated with increased treatment failure for rheumatoid arthritis patients younger than 75, but the disadvantage of TNFi monotherapy on drug survival disappeared among patients aged 75 and older.

Major finding: Patients aged 75 and older on TNFi monotherapy were more likely to discontinue because of adverse events and less likely to discontinue because of ineffectiveness (hazard ratios 1.41 and 0.66, respectively).

Study details: The data come from an analysis of 15,700 rheumatoid arthritis patients in the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis.

Disclosures: The study received no outside funding. One author reported receiving honoraria for speaking or attending conferences from Pfizer, Bristol-Myers Squibb, UCB, and Celgene. Another author is a trustee of the Kennedy Trust for Rheumatology Research, which has received royalty income linked to TNFi therapy when used in combination with methotrexate.


Bechman K et al. Rheumatology. 2020 Jan 30. doi: 10.1093/rheumatology/kez671.