biostudies-literatureDalix EMinistry of Healthe087872https://www.ebi.ac.uk/biostudies/studies/S-EPMC11409346biostudies-literatureUnknown14(9)<h4>Introduction</h4>Axial spondyloarthritis (axSpA) is a chronic inflammatory disease characterised by inflammatory low back pain. Non-steroidal anti-inflammatory drugs (NSAIDs) are recommended as a first treatment in axSpA. In case of inadequate response to NSAIDs, biological disease-modifying antirheumatic drugs (bDMARDs) should be introduced according to the recommendations of the European League Against Rheumatism (EULAR) and the American College of Rheumatology. Until 2015, only bDMARD was recommended for axSpA in case of failure to anti-tumour necrosis factor (TNF). The 2022 Assessment of SpondyloArthritis International Society (ASAS)-EULAR recommendation proposed to start an alternative bDMARD but without advocating a switch in mode of action as proposed in rheumatoid arthritis. SiBMJ openRotation or change of biotherapy after TNF blocker treatment failure for axial spondyloarthritis: the ROC-SpA study, a randomised controlled study protocol.PMC11409346PHRCN-16-0642Dernis EBejan-Angoulvant TFelten RConstantin AJorgensen CSellam JPascart TFinckh AMarotte HBouvard BGoupille PLequerre TLespessailles EDalix EGervais EWendling DAkrour MPavy SRoux CHClaudepierre PSchaeverbeke TCormier GROC-SpA study groupSalmon JHMiceli CLukas CBreban MDevauchelle VBaillet ARancon FBrocq OGoff BLPresles ETournadre ADe Araujo LGossec LMarcelli CfalseRotation or change of biotherapy after TNF blocker treatment failure for axial spondyloarthritis: the ROC-SpA study, a randomised controlled study protocol.<h4>Introduction</h4>Axial spondyloarthritis (axSpA) is a chronic inflammatory disease characterised by inflammatory low back pain. Non-steroidal anti-inflammatory drugs (NSAIDs) are recommended as a first treatment in axSpA. In case of inadequate response to NSAIDs, biological disease-modifying antirheumatic drugs (bDMARDs) should be introduced according to the recommendations of the European League Against Rheumatism (EULAR) and the American College of Rheumatology. Until 2015, only bDMARD was recommended for axSpA in case of failure to anti-tumour necrosis factor (TNF). The 2022 Assessment of SpondyloArthritis International Society (ASAS)-EULAR recommendation proposed to start an alternative bDMARD but without advocating a switch in mode of action as proposed in rheumatoid arthritis. Si2024-01-01T00:00:00Z2024 Sep2026-06-02T04:09:33.64Z2025-04-04T12:53:51.398ZS-EPMC114093463926085610.1136/bmjopen-2024-087872