Biological therapies in rheumatic diseases.
The development of the biological drugs has revolutionized the therapeutic approach of the chronic inflammatory rheumatic diseases, particularly in patients resistant to standard treatment. These drugs are characterized by an innovative mechanism of action, based on the targeted inhibition of specific molecular or cellular targets directly involved in the pathogenesis of the diseases: pro-inflammatory cytokines (tumor necrosis factor, interleukin-1 and 6), CTLA-4, and molecules involved in the activation, differentiation and maturation of B cells. Their use has indeed allowed for a better prognosis in several rheumatic diseases (such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, systemic lupus erythematosus) and to obtain a clinical remission. In the present review we give an overview of the biological drugs currently available for the treatment of the rheumatic diseases, analyzing the different mechanism of action, the therapeutic indications and efficacy data, and adverse events.
Department of Internal Medicine and Medical Specialties, Rheumatology, 'Sapienza' University, Rome, Italy.
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F
Conti
F
F
Ceccarelli
L
L
Massaro
E
E
Cipriano
M
M
Di Franco
C
C
Alessandri
F R
FR
Spinelli
R
R
Scrivo
D000069594:Abatacept; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000276:immunology / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D016175:B-Lymphocyte Subsets / Q000276:immunology; D001691:Biological Therapy / Q000009:adverse effects / Q000706:statistics & numerical data / Q000639:trends; D004359:Drug Therapy, Combination; D006801:Humans; D018796:Immunoconjugates / Q000276:immunology / Q000627:therapeutic use; D007074:Immunoglobulin G / Q000276:immunology / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007372:Interferons / Q000037:antagonists & inhibitors; D007375:Interleukin-1 / Q000037:antagonists & inhibitors; D008212:Lymphocyte Depletion; D015337:Multicenter Studies as Topic; D056687:Off-Label Use; D016032:Randomized Controlled Trials as Topic; D047889:Receptors, Tumor Necrosis Factor, Type II / Q000037:antagonists & inhibitors; D012216:Rheumatic Diseases / Q000628:therapy*; D000069283:Rituximab; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D000093242:Interleukin-6 Inhibitors; D015850:Interleukin-6
D000069594:Abatacept; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018796:Immunoconjugates; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D007372:Interferons; D007375:Interleukin-1; D047889:Receptors, Tumor Necrosis Factor, Type II; D000069283:Rituximab; D014409:Tumor Necrosis Factor-alpha; D000093242:Interleukin-6 Inhibitors; C508600:IL6 protein, human; D015850:Interleukin-6