Responses to switching TNFi in SpA go down w/ the 2nd TNFi. 1st TNFi @ 3 mos ASAS CII 51%; 2nd TNFi 41%; BASDAI @6 mo, 1st 46%, 2nd TNFi 33%. Compared to primary failure, pts w/ 2nd failure (OR 7.3 ) or toxicity (OR 9.1) had better ASDAS-I https://t.co/jMCUfBtxmY https://t.co/PBkQNOwVRQ