Biologics-Based Therapy for the Treatment of Rheumatoid Arthritis

Abstract

Rheumatoid arthritis (RA) remains a major clinical problem, but treatments involving biologics have revolutionized its management. They target pathogenically relevant cytokines such as tumor necrosis factor and immune cells such as B cells. In RA, biologics reduce joint inflammation, limit erosive damage, decrease disability, and improve quality of life. Infections are the main risk associated with their use. Because of the high prices of biologics, their cost-effectiveness is a matter of debate. They are mainly coadministered with disease-modifying drugs such as methotrexate when the latter are found to achieve insufficient disease control on their own.

Sustained Beneficial Effects of a Protocolized Treat‐to‐Target Strategy in Very Early Rheumatoid Arthritis: Three‐Year Results of the Dutch Rheumatoid Arthritis Monitoring Remission Induction Cohort

“…Intensified treatment including biologic agents has proven to be effective in achieving remission in patients with recent-onset RA (7). Clinical trials, e.g., the BeSt (Behandelstrategieën voor Reumatoide Artritis) study (8) and CAMERA (Computer-Assisted Management in Early Rheumatoid Arthritis) study (9), have demonstrated that intensive therapy including combination therapy and biologic agents or corticosteroids results in more beneficial clinical outcomes than initial monotherapy with diseasemodifying antirheumatic drugs (DMARDs).…”

Silencing the expression of connexin 43 decreases inflammation and joint destruction in experimental arthritis

“…3 However, there are caveats in using the biological preparations, including risk of infections such as tuberculosis, high cost, and individual variations in efficacy. 4 Therefore, further investigations are needed to achieve remission of arthritis.…”

Intratumoural inflammation and endocrine resistance in breast cancer

“…Inflammatory cells do not share the ability of the cancer cell population to evolve with new mutations to circumvent therapies, thus offering a potentially more stable target. Inflammation has been the focus of extensive and successful drug development, from aspirin to newer antibody-based therapies to revolutionise treatment of chronic inflammatory conditions (Scott 2012). The association between inflammation-derived cytokines and tumour progression has led to the development of targeted anti-inflammatory therapeutics including NFkB signalling inhibitors, TNF/TNFR antagonists and IL6 antagonists (Goldberg & Schwertfeger 2010, Balkwill & Mantovani 2012, Coussens et al 2013.…”