RHEUMATOID ARTHRITIS THERAPIES: PRESENT AND FUTURE

Rheumatoid Arthritis Therapies

Abstract

Rheumatoid arthritis (RA) is an autoimmune disorder characterized by inflammation of synovium, cartilage
damage and co-occurring of various other disorders. Significant improvement has been achieved in RA
therapeutics in last two decades. However, newer, more efficient and more cost-effective therapeutic applications are still needed to be developed. Current therapies in RA are mostly acting to restrict inflammation. Non steroidal anti inflammatory drugs (NSAIDs) and disease modifying antirheumatic drugs (DMARDs) are conventionally used in RA therapy. Studies showed higher efficacy of anticytokine therapy such as anti-IL-6 and anti-TNF. Rituximab, targeting B cells, after establishing its potential was approved to be used in combination with methotrexate in 2006. Abatacept, CLTA-4-IgG1, has been developed to block CD28 and CD80 or CD86 interaction leading to the termination T cell activation. Molecular inhibitors are relatively new in RA therapeutics such as tocilizumab, tofacitinib and baricitinib. FDA has approved tofacitinib to be used as a treatment for moderate andsevere RA. Future holds promising therapeutic options based on numerous studies. IL-12, IL-17 and IL-23 are the targets of future anticytokine therapies. Several lymphocyte targeting agents including ofatumumab, ocrelizumab and veltuzumab have been developed and are currently in phase II and phase III clinical trials. There is a vast range of potential targets in RA enabling us to expand the therapeutic options over the next decade.