[New therapies for rheumatoid arthritis]

Med Clin (Barc). 2014 Nov 18;143(10):461-6. doi: 10.1016/j.medcli.2013.11.011. Epub 2014 Jan 22.
[Article in Spanish]

Abstract

Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease characterized by inflammation of the synovial membrane and progressive destruction of the articular cartilage and bone. Advances in the knowledge of disease pathogenesis allowed the identification of novel therapeutic targets such as tumor necrosis factor (TNF), interleukin (IL)-1, IL-6 or the system JAK/STAT phosphorylation. At present there are 5 TNF antagonists approved for RA. Tocilizumab blocks the pathway of IL-6 and is the only biological with proven efficacy in monotherapy. Rituximab modulates B cell response in RA. Abatacept provided new data on T cell involvement in the pathogenesis of RA. Tofacitinib is the first kinase inhibitor approved for this disease. Biologic drugs have proven efficacy, almost always in combination with methotrexate, and even halt radiographic progression. Monitoring infection is the main precaution in handling these patients.

Keywords: Antagonistas del factor de necrosis tumoral; Artritis reumatoide; Biological therapy; Rheumatoid arthritis; Terapia biológica; Tratamiento; Treatment; Tumor necrosis factor antagonists.

Publication types

  • Review

MeSH terms

  • Abatacept / therapeutic use
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Rheumatoid / drug therapy*
  • Humans
  • Piperidines / therapeutic use
  • Pyrimidines / therapeutic use
  • Pyrroles / therapeutic use
  • Rituximab / therapeutic use
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antirheumatic Agents
  • Piperidines
  • Pyrimidines
  • Pyrroles
  • Tumor Necrosis Factor-alpha
  • Rituximab
  • Abatacept
  • tofacitinib
  • tocilizumab