biostudies-literatureZhao SSVersus ArthritisBritish Society for RheumatologyBSR Biologics Register in Rheumatoid ArthritisNational Institute for Health Research (NIHR)NIHR Manchester Biomedical Research Centre4678-4686https://www.ebi.ac.uk/biostudies/studies/S-EPMC9707051biostudies-literatureUnknown61(12)<h4>Objectives</h4>Whether patients with RA benefit from repeated trials of biologic or targeted synthetic DMARDs (b/tsDMARDs) after three or more attempts is unknown. We aimed to describe treatment outcomes in each line of b/tsDMARD therapy.<h4>Methods</h4>Using data from the British Society for Rheumatology Biologics Register for RA from 2001 to 2020, change to a new b/tsDMARD (except biosimilar switches) was defined as a new line of therapy. Treatment outcomes were compared across lines of therapy, including DAS28 remission (≤2.6), low disease activity (LDA, ≤3.2) at 6 months and median time to drug discontinuation. Multiple imputation was used for missing data.<h4>Results</h4>A total of 22 934 individuals starting a first b/tsDMARD were included (mean age 56 years, 76% female), among wRheumatology (Oxford, England)Effectiveness of sequential biologic and targeted disease modifying anti-rheumatic drugs for rheumatoid arthritis.PMC970705121755BSRBR-RA Contributors GroupZhao SSBosworth AHyrich KLKearsley-Fleet LWatson KfalseEffectiveness of sequential biologic and targeted disease modifying anti-rheumatic drugs for rheumatoid arthritis.<h4>Objectives</h4>Whether patients with RA benefit from repeated trials of biologic or targeted synthetic DMARDs (b/tsDMARDs) after three or more attempts is unknown. We aimed to describe treatment outcomes in each line of b/tsDMARD therapy.<h4>Methods</h4>Using data from the British Society for Rheumatology Biologics Register for RA from 2001 to 2020, change to a new b/tsDMARD (except biosimilar switches) was defined as a new line of therapy. Treatment outcomes were compared across lines of therapy, including DAS28 remission (≤2.6), low disease activity (LDA, ≤3.2) at 6 months and median time to drug discontinuation. Multiple imputation was used for missing data.<h4>Results</h4>A total of 22 934 individuals starting a first b/tsDMARD were included (mean age 56 years, 76% female), among w2022-01-01T00:00:00Z2022 Nov2025-04-05T09:43:10.089Z2025-04-05T09:43:10.089ZS-EPMC97070513535742110.1093/rheumatology/keac190