[Can two biologicals be combined to treat rheumatoid arthritis?]

Selective anticytokine therapy improves clinical outcome in patients with rheumatoid arthritis but does not produce complete remission. The inflammatory network with multiple cell types and cytokines is a multi-factorial phenomenon involving the synovial membrane. Specific inhibition of one factor may result in activation of an alternative (by-pass) route. Thus, the search continues for novel, more aggressive combination therapies. It seems possible to administer a combination of anticytokine drugs or to combine one anticytokine with one B cell-depleting agent (different mechanisms of action). Initial reports on this combination therapy show that it is relatively effective and safe, especially as regards the second option. Results of ongoing clinical trials as well as information on the cost-effectiveness of these therapies are awaited.