title: RADIATE: more treatment options for patients with an inadequate response to tumor necrosis factor antagonists.
abstract: Over the last decade, the use of tumor necrosis factor (TNF) inhibitors has improved the prognosis of patients with rheumatoid arthritis. Although these agents are more efficacious than traditional DMARDs, a substantial proportion of patients discontinue anti-TNF therapy because of adverse effects or lack of efficacy. Therapeutic options for these patients include dose increases, switching to an alternative TNF antagonist, or switching to a biologic of a different class, such as rituximab or abatacept. The recently published results of the RADIATE study by Emery et al. suggest that the interleukin-6 inhibitor tocilizumab is a safe and effective alternative for patients who fail to respond to anti-TNF therapy. Randomized controlled trials and the study of biomarkers are needed to help clinicians select the most suitable of these options for their patients.
authors.affiliation: Academic Department of Rheumatology, King's College London, London, UK. ernest.choy@kcl.ac.uk
authors.forename: Ernest
authors.initials: E
authors.lastname: Choy