RESEARCH - RA: non-tumor necrosis factor targets.

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Curr Opin Rheumatol. 2005 May;17(3):242-246.

Rheumatoid arthritis: non-tumor necrosis factor targets.

Pollard L, Choy E.

Sir Alfred Baring Garrod Clinical Trials Unit, Department of Academic

Rheumatology, King's College, London Weston Education Centre, London, UK.

PURPOSE OF REVIEW: The treatment of rheumatoid arthritis has been

revolutionised in recent years with the advent of biologic treatments. The

purpose of this review is to outline new treatments that target the

inflammatory pathway in rheumatoid arthritis other than tumor necrosis

factor-alpha. RECENT FINDINGS: As the use of anti-tumor necrosis

factor-alpha treatment has become more widespread, the number of patients in

whom this treatment is unsuccessful has also accumulated. Contraindications

such as infection and cardiac failure further add to the number of patients

who need alternative treatment. A better understanding of the inflammatory

pathway in rheumatoid arthritis has led to interest in other therapeutic

targets. Promising treatments such as interleukin-6 antagonists (MRA),

CTLA4Ig (abatacept), and anti-B cell therapy (rituximab) have already been

tested in randomized controlled trials over the past year. Other cytokines

have been identified and have been shown to be of benefit in animal models,

including interleukin-15, interleukin-17, and interleukin-18, and clinical

trials of these agents are currently under way.

SUMMARY: For patients with rheumatoid arthritis that does not respond to

anti-tumor necrosis factor-alpha treatment, the promising alternatives MRA,

abatacept, and rituximab have been tested. It is hoped that these agents

will become available shortly.

PMID: 15838231

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

5838231 & dopt=Abstract

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