Current pharmacological therapy for rheumatoid arthritis, factors for its effectiveness and associated complications: systematic review

Abstract

Rheumatoid arthritis (RA) is a chronic, autoimmune, and systemic inflammatory disease that mainly affects diarthrodial joints. Its global prevalence is 0,5-1 % in adults, increasing to 5 % in women over 55 years old. RA reduces the quality of life and life expectancy by 3-10 years, mainly due to associated cardiovascular diseases. Current treatment is based on initiating early disease-modifying therapy with the goal of suppressing inflammation, inducing remission, preventing joint damage, and improving functionality. Antirheumatic medications include non-steroidal anti-inflammatory drugs, glucocorticoids, non-biological immunosuppressants like methotrexate, and biological immunomodulators such as anti-TNF or anti-interleukins, which have shown high clinical effectiveness. However, there is individual variability in therapeutic response, adverse effects, and loss of efficacy over time. This study conducted a systematic literature review following the PRISMA methodology. The search was performed on PubMed, Scopus, and Web of Science, using MESH terms and keywords related to rheumatoid arthritis, treatments, effectiveness, and prognostic factors. Studies published between 2015-2022 were included, ultimately selecting 30 articles that met eligibility criteria. The objective of this review was to compile and synthesize available evidence on currently used medications and therapies for rheumatoid arthritis, factors associated with therapeutic success, and the most frequently reported complications or adverse effects. The results contribute to enhancing treatment strategies, considering a personalized approach based on each patient's needs.