Rheumatoid arthritis (RA) is the prototypical and most common inflammatory joint disease. Uncontrolled inflammatory disease activity leads to structural damage of the joints with loss of function and impairment of quality of life. Additionally, persistent systemic inflammation is also associated with cardiovascular diseases, multi-organ involvement and reduced life expectancy. Within the past decade, several new therapeutic options have been developed. Therapeutic biologicals targeting distinct pathogenic pathways, such as cytokines (TNF alpha , IL-1, IL-6) as well as co-stimulatory molecules (CTLA4-Ig) and B-cells, have revolutionized treatment outcomes. Despite these available treatment options, there is still a medical need for further safe and effective drugs. Therapy of RA must be given life-long and all available drugs face the problem of breakthrough disease activation or primary and secondary non-responsiveness.
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