title: Therapeutic options for rheumatoid arthritis.
abstract: BACKGROUND
  Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disorder primarily targeting the synovium. Unchecked disease activity is associated with significant morbidity and an increased mortality. Recent advances in the understanding of the pathogenesis of RA and the capability of biologically engineered treatments for RA have expanded the armamentarium of antirheumatic agents.
  
  
  METHODS
  A systematic literature review was conducted through PubMed.
  
  
  CONCLUSIONS
  At present, a common strategy for the treatment of RA uses methotrexate either as monotherapy or in combination with a variety of conventional and/or biologic disease-modifying antirheumatic drugs (DMARDs), with the goal of inducing remission of active disease. The choice of which agent(s) to use is based upon patient-specific criteria (activity of disease, comorbidities, patient preferences, costs etc.). Emerging therapies that target specific cytokines and growth factors in the inflammatory cascade of RA offer a potent new means of modifying disease activity, but many questions regarding their use remain unanswered.
authors.affiliation: University of Nebraska Medical Center, Section of Rheumatology and Immunology, Department of Internal Medicine, 983025 Nebraska Medical Center, Omaha, NE 68198 - 3025, USA. mfeely@unmc.edu
authors.forename: Michael G
authors.initials: MG
authors.lastname: Feely
authors.forename: Alan
authors.initials: A
authors.lastname: Erickson
authors.forename: James R
authors.initials: JR
authors.lastname: O'Dell
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000191:economics / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000503:physiopathology; D004359:Drug Therapy, Combination; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008727:Methotrexate / Q000627:therapeutic use*; D012074:Remission Induction
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D007166:Immunosuppressive Agents; D008727:Methotrexate