Biological therapy in rheumatoid arthritis: current status

With the development of biological agents our therapeutic approach to rheumatoid arthritis (RA) and inflammatory diseases in general, has dramatically changed in the last few years. Recently, a number of endogenous molecules have been identified that are known to activate CD4+ T cells leading to production of cytokines (IL-1, IL-6 and TNF-α), immunoglobulins like rheumatoid factor and expression of osteoprotegerin ligands that stimulate osteoge-nesis leading to joint destruction. This has led to better insight into the disease mechanisms. As a result, there is a wave of new therapies for RA like infliximab, adalimumab, atlizumab, etanercept, anakinra, prosorba column, abatacept, anti-IL-6 agents, IL-10 and interferon-γ. To date, combination therapy of methotrexate and a single biological has been widely studied with synergistic effect. Etanercept and infliximab are the two biologicals available in India. Present article can prove useful for the physicians to get an insight into these novel therapeutic options for RA.