Biologic treatments for systemic rheumatic diseases

Abstract

Many rheumatologic disorders, most notably Sjögren's syndrome, are associated with dental complications and in some cases oral diseases may trigger or drive connective tissue disease. 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 mechanisms of inflammation and autoimmunity and the invention of new target-specific biologic agents. In this review, we will summarize the current state of biologic therapies in rheumatology and discuss the implications of these on oral health and disease.

Figure 1

Targets of biologic therapies: Mab, monoclonal antibody/biologic agent. (A) Biologic agent targeting membrane-bound molecules. Examples: anti-TNF (infliximab, adalimumab), anti-IL-6 receptor (tocilizumab), IL-1 receptor antagonist (anakinra), CTLA4 Ig (abatacept). (B) Biologic agent targeting soluble molecules. Examples: anti-TNF (infliximab, adalimumab), anti-BLyS (belimumab). TNF, tumor necrosis factor; IL, interleukin; CD, cluster of differentiation; BLyS, B lymphocyte stimulator