The therapeutic journey of biologic agents: There will be an end?

Over the last 30 years, major advances in our understanding of the pathogenesis of systemic rheumatic diseases have improved clinicians' therapeutic armamentarium. Despite these successes, it needs to be borne in mind that none of these drugs are "intelligent" and they are all intrinsically capable of giving rise to adverse events. A number of biological drugs are being tested in various clinical trials as well in observational studies. The patents of various anti-TNF agents have recently expired, and this has led to the marketing of biosimilars, but at the same time a targeted synthetic DMARDs appear, that targeting various cytokines instead of one as the biological DMARDs have been done.