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One year in review

 

One year in review 2019: novelties in the treatment of rheumatoid arthritis

1, 2, 3, 4, 5, 6

 

  1. Rheumatology Unit, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliero-Universitaria S. Anna, Cona, Ferrara, Italy. ettore.silvagni@student.unife.it
  2. Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy.
  3. Rheumatology Unit, Department of Medicine, University of Perugia, Italy.
  4. Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy.
  5. Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy.
  6. Rheumatology Unit, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliero-Universitaria S. Anna, Cona, Ferrara, and Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy.

CER12292
2019 Vol.37, N°4
PI 0519, PF 0534
One year in review

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PMID: 31140394 [PubMed]

Received: 01/04/2019
Accepted : 02/05/2019
In Press: 24/05/2019
Published: 27/06/2019

Abstract

The current treatment approach in rheumatoid arthritis (RA) follows a stepwise management, starting from early introduction of conventional synthetic (cs) disease-modifying anti-rheumatic drugs (DMARDs), moving to biological (b) DMARDs and targeted synthetic (ts) DMARDs. In the last few years, new drugs with different mechanisms of action have demonstrated their efficacy in treating such a disabling condition, and their approval, along with other more “experienced” treatments, has established their effectiveness on disease activity, damage accrual prevention, patients’ quality of life improvement, confirming their safety profile. Moreover, new molecular pathways are under investigation as potential targets of new advanced therapies. Clinicians’ capability of stratifying treatment strategies and decisions has improved, with several new tools for the optimisation of long-term management of RA; however, a high proportion of patients are refractory to the available drugs. Finally, as RA is a systemic disease, the knowledge in multi-systemic complications of the disease has grown, as well as the possibility in improving extra-articular manifestations of the disease, although certain drugs have potentially relevant non-articular effects, which need to be monitored. This narrative review summarises the most relevant studies published over the last year in the field of treatment of RA, with the major aim to let clinicians and researchers reflect on “what is new”, “what is effective” and “what is safe”.

Rheumatology Article