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An increased understanding of the molecular pathogenesis of RA has led to significant advances in biologic therapies in the past 15 years and has dramatically changed the treatment paradigm for RA.3 Currently, 4 classes of biologic DMARDs are available, including (1) the tumor necrosis factor (TNF)-α inhibitors adalimumab, certolizumab pegol, etanercept, golimumab, and infliximab; (2) abatacept, which blocks T-cell costimulation via anti-CD80/86 inhibition; (3) the anti-CD20 agent that causes B-cell depletion, rituximab; and (4) the interleukin (IL)-6 receptor (IL-6R) blocker, tocilizumab.
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