Rheumatoid arthritis: an evolutionary force in biologics

Current Pharmaceutical Design
Philip M Brown, John D Isaacs

Abstract

The advent of biologic therapy has transformed the outcomes of patients with Rheumatoid Arthritis (RA), but has also highlighted important issues for their development. Early attempts at T-cell driven therapies gave mixed results with difficulties extrapolating from non-human models to first in man trials. There is currently one T-cell modulating therapy - abatacept - licenced for use in RA. Cytokine inhibition has proven to be more fruitful with a number of anti-TNF and IL6 agents either licenced for use in RA or in development. The B-cell depleting therapy rituximab has also shown good efficacy as a chemotherapy agent repurposed for RA treatment. Overall the biologics show good efficacy in RA and have been shown to retard progression of radiographic joint damage. However, this benefit comes with a burden of increased infection risk and a financial cost significantly higher than conventional disease modifying therapies. As a result current UK licencing holds the biologics in reserve following failure of a conventional therapy and the presence of moderate to severely active disease. The long term use of the biologics in RA has highlighted the risk of immunogenicity, with significant proportions of patients developing anti-drug ...Continue Reading

Citations

Dec 19, 2015·Expert Review of Clinical Immunology·Maurizio CutoloCarmen Pizzorni
Nov 4, 2016·BioDrugs : Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy·Ira JacobsSadiq Lula
Jan 10, 2018·British Journal of Clinical Pharmacology·Carla BastidaDolors Soy
Dec 19, 2016·British Journal of Clinical Pharmacology·Carla BastidaDolors Soy
Feb 18, 2017·Immunopharmacology and Immunotoxicology·Yasmin Moustafa AhmedAli Ahmed Abo-Saif
Mar 7, 2021·Biomedicines·Francesc VenturaGonzalo Sanchez-Duffhues

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