Advances in rheumatoid arthritis

Summary

• There are now eight approved biological disease-modifying antirheumatic drugs (bDMARDs), two biosimilars and one targeted synthetic DMARD in Australia with a number of new products and biosimilars in the pipeline.
• bDMARDs have excellent efficacy, especially when combined with traditional DMARDs, and a well characterised but manageable safety profile.
• These expanded therapeutic options have revolutionised patient care and made remission (including drug free remission) a realistic goal.
• Evidence of a “window of opportunity” that changes the long term phenotype of the disease has been well established, so therapy should be commenced as early as possible in the disease process and a shared care model between general practitioner and rheumatologist provides the best outcomes.
• While there is no cure for rheumatoid arthritis, treatment has improved to the point where many patients can achieve a normal quality of life.