Abstract
Background: Biologic drugs, introduced in clinical practice almost twenty years ago, represent nowadays a prominent treatment option in patients with chronic inflammatory arthritis, such as Rheumatoid Arthritis, Psoriatic Arthritis and Spondyloarthritis, that include ankylosing spondylitis and non-radiographic axial spondyloarthritis.
Methods: Several compounds targeting different pathways have been marketed and approved for the treatment of inflammatory arthritis, with a significant impact on the clinical outcomes and the natural history of the diseases.
Results: There are currently seven classes of biologics that are available for the treatment of inflammatory arthritis, each inhibiting a different aspect of the immune-driven inflammatory pathway.
They include:
• Tumor Necrosis Factor (TNF) inhibitors (infliximab, adalimumab, etanercept, golimumab and certolizumab pegol);
• Interleukin-1 (IL-1) receptor antagonists (anakinra);
• Interleukin-6 (IL-6) inhibition (tocilizumab);
• Interleukin-12/23 (IL23) inhibition (ustekinumab);
• Interleukin-17 (IL-17) inhibition (secukinumab);
• B-cell inhibition (anti-CD20, rituximab);
• T-cell costimulation inhibition (anti-CTLA-4, abatacept).
Conclusion: In this review, we will focus on the role of biologic drugs in the treatment strategies for inflammatory arthritis.
Keywords: Biologic drugs, TNF inhibitors, rheumatoid arthritis, spondyloarthritis, psoriatic arthritis, efficacy, safety.
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