Korean J Med.  2012 May;82(5):549-561.

Biologic Agents in Rheumatic Diseases

• Hong MJ
• Yoo WH

Abstract

During the past three decades the treatment in rheumatology was revolutionized by the introduction of disease-modifying anti-rheumatic drugs. Advances in our understanding of the pathogenesis of rheumatic diseases have led to the discovery of critical pathogenetic mechanisms of inflammation and autoimmunity and the invention of new target-specific biologic agents. The development of biologic agents led to a new era in treatment of various rheumatic diseases. Treatments of rheumatic diseases such as rheumatoid arthritis (RA) had been very difficult in former days until conventional DMARDs was developed. Although synthetic DMARDs made it a lot easier to control rheumatic diseases, still, there were some difficulties on controlling diseases. The biologic agents inhibit specific pro-inflammatory cytokines as a targeted therapy to prevent inflammation and destruction of affected joint and/or tissues. Three TNF blocking agents, etanercept, infliximab and adalimumab, are the most well recognized and widely used biologic agents in RA, ankylosing spondylitis (AS), and some other inflammatory autoimmune diseases. Furthermore, an inhibitor of IL-1 (anakinra), a B-cell depleting drug (rituximab) and an inhibitor of T-cell costimulation (abatacept) are developed in turn asnovel biologic agents which are believed to be effective in number of rheumatic diseases. Recently, an inhibitor of IL-6 (tocilizumab) and 2 other TNF inhibitors (golimumab and certolizumab) are developed. Here, the brief descriptions of recently used biologic agents and their efficacies and safeties are discussed.

Keyword

Biologic therapy; Fusion protein; Monoclonal antibody; Rheumatic disease

MeSH Terms

Antibodies, Monoclonal
Antibodies, Monoclonal, Humanized
Antirheumatic Agents
Arthritis, Rheumatoid
Autoimmune Diseases
Autoimmunity
B-Lymphocytes
Biological Therapy
Cytokines
Immunoglobulin G
Inflammation
Interleukin-1
Interleukin-6
Inventions
Joints
Receptors, Tumor Necrosis Factor
Rheumatic Diseases
Rheumatology
Safety
Spondylitis, Ankylosing
T-Lymphocytes
Adalimumab
Infliximab
Etanercept
Antibodies, Monoclonal
Antibodies, Monoclonal, Humanized
Antirheumatic Agents
Cytokines
Immunoglobulin G
Interleukin-1
Interleukin-6
Receptors, Tumor Necrosis Factor