Biological therapies for rheumatoid arthritis: beyond TNF-α blockade

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Biological therapies represent one of the major advances in the treatment of rheumatoid arthritis in the past decade. The tumour necrosis factor alpha (TNF-α) inhibitors have started marketing in most Asian countries. Despite having a higher efficacy than conventional disease-modifying antirheumatic drugs (DMARDs), the anti-TNF-α agents are not successful in all patients with rheumatoid arthritis. Moreover, short-term and long-term complications such as tuberculous infection and lymphoma are still a major concern. Recent studies have demonstrated that several non-TNF-α biologics such as rituximab, abatacept and tocilizumab are effective in patients with refractory rheumatoid arthritis, including those who are not responsive to the TNF-α inhibitors. This article updates the clinical data on the recently developed non-TNF-α biological agents in rheumatoid arthritis.

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