[Current conception of rheumatoid polyarthritis treatment: towards a therapeutic revolution?]

Rheumatoid arthritis (RA) is a frequent, heterogenous crippling disease. The diagnosis must be made as soon as possible in order to begin quickly the treatment. The improvement of our knowledge in the immunopathology of RA allowed the development of new biotherapies directed against harmful mediators such as TNF alpha and Interleukin 1. With anti-TNF alpha agents excellent clinical and biological results are observed in methotrexate refractory RA patients in 70% of cases. Moreover these drugs are able to stop the X ray evolution of the disease. They can be considered as a very important new step in the treatment of RA. Other targeted drugs such as anti-IL1, anti-IL6 agents, anti-B lymphocytes monoclonal antibody (Rituximab), CTL4 IgG are already used or under study. In this paper the modern treatment of RA is reviewed with a special emphasis on anti-TNF alpha and anti-IL1 biotherapies.