title: [Combination of biologics : where do we stand?].
abstract: BACKGROUND
  Data with respect to safety and therapeutic efficacy for the combination of biological DMARDs is scarce and inhomogeneous in order to make final conclusions. To this end, data to biologic combinations is disappointing due to relatively low therapeutic efficacy and partially enhanced rates of severe infectious events.
  
  
  METHODS
  Combining biologics is an option only in very special situations (RTX plus TNFi). In addition, the relation of financial effort to therapeutic efficacy is questionable, especially in the situation of numerous drug options (anti-cytokine principle, T-cell inhibition, B-cell depletion) and therapeutic strategies of combining biologics with DMARDs. Generally speaking, combinations of biological should only be used in clinical trials. New drugs influencing intracellular signaling pathways (small molecules) are going to be approved or are already approved by the drug agencies, thus, adding to the existing armamentarium. Furthermore, combinations with these new molecules are going to be interesting.
  
  
  CONCLUSIONS
  This review summarizes the available studies concerning combination of biologicals in a tabular fashion.
authors.affiliation: Klinik für Rheumatologie, Klinische Immunologie und Physikalische Therapie, Katholisches Klinikum Mainz, An der Goldgrube 11, 55131, Mainz, Deutschland, p-haerle@kkmainz.de.
authors.forename: P
authors.initials: P
authors.lastname: Härle
mesh_terms: D018501:Antirheumatic Agents / Q000008:administration & dosage*; D001688:Biological Products / Q000008:administration & dosage*; D004338:Drug Combinations; D015195:Drug Design; D006801:Humans; D012216:Rheumatic Diseases / Q000188:drug therapy*
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products; D004338:Drug Combinations