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Rheumatoid Arthritis is a progressive and systemic inflammatory disorder of unknown etiology that frequently leads to joint destruction accompanied by multi-system extra-articular manifestations. No curative therapy is available today. Compared to usual Disease Modifying Antirheumatic Drugs (DMARDs), biologicals such as tumor necrosis factor (TNF) α- and interleukin (IL) 1-inhibitors appear to offer greater efficacy and safety, especially in refractory cases. This article deals with the new agents infliximab, etanercept, and anakinra as well as with additional newly developed cytokine-inhibitors. In order to control their use and possible unknown long-term effects, a network of international and national committees has been installed. The actual recommendations for the treatment of rheumatoid arthritis with biologicals are presented, and the cost-benefit relation is discussed.