When considering a biologic for seropositive RA after failure of methotrexate or triple therapy, do you consider using abatacept as a first line biologic or would prefer choosing TNFi?  

Data is very limited on the superiority of one class of biologic drug versus another. The American College of Rheumatology and the European League Against Rheumatism do not mention bDMARD's preference for a first-line biologic in their respective guidelines for the management of RA. They do emphasiz...

I basically agree with Dr. @Ware, as do many others. Most providers opt for a TNF antagonist as a first option in an MTX-IR situation. Unresolved, however, is the finding that anti-CCP titers and the presence of the shared epitope appear to predict enhanced responses to abatacept (PMID: Sokolove et ...