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Pathogenesis of rheumatoid arthritis: targeting cytokines

Jochen Zwerina1, Kurt Redlich, Georg Schett

  • 1Division of Rheumatology, Internal Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.

Annals of the New York Academy of Sciences
|August 30, 2005
PubMed

Insights

New biologic therapies targeting cytokines like TNF, IL-1, IL-6, and IL-15 show promise for rheumatoid arthritis (RA) treatment. These advanced treatments, often combined with methotrexate, can significantly improve RA symptoms and quality of life.

Area of Science:

  • Rheumatology
  • Immunology
  • Pharmacology

Background:

  • Rheumatoid arthritis (RA) treatment remains challenging despite traditional disease-modifying antirheumatic drugs (DMARDs).
  • Cytokines such as tumor necrosis factor (TNF), interleukin-1 (IL-1), interleukin-6 (IL-6), and interleukin-15 (IL-15) play key roles in RA pathogenesis.
  • The development of anticytokine therapies (biologicals) has emerged as a significant advancement.

Purpose of the Study:

  • To review the efficacy of biological therapies targeting specific cytokines in rheumatoid arthritis.
  • To assess the impact of these therapies on disease activity, radiographic progression, and quality of life.
  • To explore the potential of combination biological therapies for achieving remission or cure in RA.

Main Methods:

  • Review of clinical trials on anticytokine therapies for rheumatoid arthritis.
  • Analysis of data on the efficacy of TNF, IL-1, IL-6, and IL-15 inhibitors.
  • Evaluation of treatment outcomes, including clinical improvement, radiographic progression, and quality of life.

Main Results:

  • Blocking TNF and IL-1 has shown benefits in DMARD-resistant RA patients, including halting radiographic progression.
  • Biological inhibitors of IL-6 and IL-15 demonstrate significant therapeutic benefits comparable to TNF blockers.
  • These biological agents are most effective when used in combination with methotrexate.

Conclusions:

  • Anticytokine therapies offer improved disease activity and quality of life for many RA patients.
  • While complete remission is challenging, these biologicals represent a major therapeutic advance.
  • Combination biological therapies may offer a pathway to enhanced success, potentially leading to remission or cure.

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