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Tumour necrosis factor inhibitors (TNFi) like Infliximab, Etarnacept and Adalimumab have been successfully studied in controlled clinical trials and are currently recommended in the treatment of patients with spondyloarthropathy (SPA). Significant proportion of patients in clinical studies have, however, failed to achieve a desired clinical response, or, are discontinued from the therapy due to secondary inefficacy or side effects. Therefore, owing to the different molecular structures and routes of administration, switching from one TNFi to another is considered as in important option in SPA patients eligible to receive TNFi therapy.
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