Rheumatoid arthritis and the evolution of therapy: from symptomatic to bench-to-bedside biological drugs

Abstract

Although treatment of rheumatoid arthritis was formerly based on the use of classical drugs, which admittedly had proved their efficacy in controlling the disease but whose exact mechanism of action remained unclear (or unknown), recent impressive advances in basic research on rheumatoid arthritis physiopathology have been made, leading directly to science-driven therapy of high specificity. In addition, an increasing number of potential targets are gradually being discovered, with subsequent engineering of – potentially therapeutic – interfering molecules. Beside the actually widely used tumor necrosis factor-blocking drugs, numerous treatments were thus developed, which focus on various levels of the complex immune process perpetuating the disease. If current clinical practice already allows the practitioner to choose between several highly efficient drugs, the exponential development of alternative therapies may complicate the decision, but should also transform long-term prognosis of these patients.