title: New biologics for rheumatoid arthritis.
abstract: Rheumatoid arthritis (RA) is a chronic inflammatory arthritis with many systemic manifestations. Several monoclonal antibodies targeting different components of the immune systems have been licensed for treatment of RA. Inflammatory cytokines such as interleukin-6 (IL-6) are found abundantly in the blood and the joints. The biologic effect of IL-6 on leukocyte, osteoclast, hepatocytes and bone marrow may mediate the articular and systemic inflammation in RA. Recently, an anti-IL-6 receptor monoclonal antibody, tocilizumab, has been licensed for the treatment as monotherapy or in combination with methotrexate of moderate to severe RA, when disease modifying anti-rheumatic drugs or anti-tumour necrosis factors (TNF) have failed. It improves symptoms and signs as well as reducing joint damage. Tocilizumab monotherapy has been shown to be superior to methotrexate. Its side-effects include infections, decrease in neutrophils, and increases in lipid and liver transaminases. Overall, tocilizumab has a well-defined and manageable safety profile that supports a favourable benefit/risk ratio for patients with RA.
authors.affiliation: Section of Rheumatology, Department of Medicine, Cardiff University School of Medicine, Cardiff, UK. ChoyEH@cardiff.ac.uk
authors.forename: E
authors.initials: E
authors.lastname: Choy
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D001688:Biological Products / Q000494:pharmacology / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D015850:Interleukin-6 / Q000276:immunology*; D007596:Joints / Q000187:drug effects* / Q000473:pathology; D008727:Methotrexate / Q000627:therapeutic use; D048069:Tumor Necrosis Factors / Q000378:metabolism
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D001688:Biological Products; D015850:Interleukin-6; D048069:Tumor Necrosis Factors; C502936:tocilizumab; D008727:Methotrexate