When patients with rheumatoid arthritis fail tumour necrosis factor inhibitors: what is the next step?

The advent of biological agents in general and tumour necrosis factor (TNF) inhibitors in particular has dramatically changed the outcomes and outlooks for patients with rheumatoid arthritis (RA).1 Not only have they expanded the treatment options in quantitative terms, but their combination with methotrexate (MTX) or other disease-modifying antirheumatic drugs (DMARDs) has also led to a quantitative revolution in the therapeutic response of...