New treatments for inflammatory rheumatic disease

Abstract

As our understanding of the pathogenesis of autoimmune diseases is growing, new therapies are being developed to target disease-specific pathways. Since the introduction of etanercept in 1998, several biotechnological agents have been developed, most of them indicated in the treatment of rheumatoid arthritis, but also psoriatic arthritis. Most currently available molecules target TNF-alfa with different strategies (i.e., etanercept, infliximab, adalimumab, golimumab, and certolizumab pegol), IL-6 (tocilizumab), CTLA-4 (abatacept), and B cells (rituximab, belimumab) as they are key mediators in the cascade of inflammation. Further, small molecules have been recently developed to target intracellular signaling, such as Janus Kinases for tofacitinib, the first FDA-approved small molecule for rheumatoid arthritis. Most novel treatments are being developed for arthritis with specific differences between rheumatoid and psoriatic arthritis, as well as for systemic lupus erythematosus, following the approval of belimumab. Finally, biologic therapies are effective also in gout, mainly targeting interleukin-1 to block the inflammasome. This review article describes the new and upcoming treatment options for rheumatoid arthritis, psoriatic arthritis, systemic lupus erythematosus, and gout to dissect what we should be aware of when discussing these new and promising molecules.

The role of BAFF in the progression of rheumatoid arthritis

“…Thus, BAFF has been regarded as a new therapeutic target in such diseases [5,36,71,91]. To date, some BAFF antagonists are in development for the treatment of RA (Table 2) …”

Inhibition of Inflammation‐Associated Olfactory Loss by Etanercept in an Inducible Olfactory Inflammation Mouse Model

“…It was developed to treat autoimmune diseases such as rheumatoid arthritis and ankylosing spondylitis. 13,15,16 Its pharmacological action is effected by binding to TNF-α, thus inhibiting the biological activity of that potent inflammatory cytokine. Although Etanercept was designed to target human TNF-α-related autoimmune inflammatory disease, there have been several studies in which Etanercept was used to successfully control inflammation in various mouse disease models.…”

Chemokine and chemokine receptors in autoimmunity: the case of primary biliary cholangitis

“…In spite of the rapid progress in our understanding the functions of chemokines and their receptors in the immune system physiologically and pathologically, further elucidation of the molecular mechanisms and their regulation in vivo are awaited. In the meantime, monoclonal antibodies and small molecules are being proposed to treat chronic autoimmune diseases, as well exemplified by the large number of approaches used in rheumatoid and psoriatic arthritis [161], but data are largely inconclusive. A stronger contamination between areas of clinical and basic research may provide answers to the remaining major questions in PBC as in other areas; this may ultimately lead to the fulfillment of the domino prophecy in which finding the key to one autoimmune disease may well lead to a faster understanding of other unrelated conditions.…”