Anti-TNF treatments have given patients with rheumatoid arthritis considerable 
hope and relief. However, 20-30% of patients do not respond sufficiently to a 
given anti-TNF drug. In this situation, current strategies include switching to 
an alternative agent, increasing the dose of the current agent or to return to 
conventional DMARDs. The arrival of new biologics, which target different 
molecules than TNF, opens the perspective to other pathways of immunomodulation 
in RA. These drugs include rituximab (anti-CD20), abatacept (CTLA4Ig) and 
tocilizumab (anti- IL6R). Comparative studies are urgently needed to assess the 
efficacy of the different treatment options in order to provide the best 
therapeutic strategy for our patients.