[Treatment of rheumatoid arthritis: current and future]

Abstract

Rheumatoid arthritis (RA) is a chronic articular inflammatory disease of unknown aetiology. The therapeutic approach can be achieved at different levels: 1) symptomatic treatment with nonsteroidal anti-inflammatory drugs which can relieve articular pain and stiffness, 2) second-line drugs (or DMARD, for Disease Modifying Anti-Rheumatic Drug) selected for their capacity to slow the rheumatoid process. During this last decade, sulfasalazine and methotrexate became an alternative choice to the "classical" slow-acting antirheumatic drugs such as gold, D-penicillamine or antimalarials. The extensive progress in basic immunology and especially in the immunopathology of RA has allowed the elaboration of a new approach to immunotherapy, aimed at molecular targets on cells from the "specific immunity" system or against mediators of the inflammatory process, such as the cytokines.