Following on from an earlier article by these authors on tumour necrosis factor (TNF) inhibitors for rheumatoid arthritis, this second article focuses on the non-TNF inhibitors. These highly effective biological therapies have radically changed how rheumatoid arthritis is managed, helping patients achieve not only disease control but also long-term remission.
Therapy for rheumatoid arthritis (RA) is directed at interrupting the inflammatory process, which, left unchecked, causes irreversible joint damage, deformity and long-term functional impairment. The earlier therapy is initiated, the better the long-term outcomes in patients with RA. Methotrexate is the main disease-modifying antirheumatic drug (DMARD) used for the treatment of RA and remains the gold standard of first-line therapy. However, an emerging class of biological DMARDs is now available for patients who fail to respond to methotrexate monotherapy and/or combination therapy with other traditional DMARDs. Treatment with these new biological DMARDs is designed to specifically target the immune response underlying the development and progression of RA.