Table 3.

Expert consensus recommendations for switching biologics

In case of efficacy failure - No washout period is needed, and new biologic can be initiated at the next dose.

Primary failure

Primary failure to TNF inhibitor, switch the drug class (switch to secukinumab).

In case of primary failure to secukinumab, switch to TNF inhibitors.

Secondary Failure

Switching can be done within the classes.

In case of safety concerns - Wait for four half-lives or till concerned safety parameter has normalized/stabilized