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Recent research has shown that in the processes of rheumatoid arthritis (RA), interleukin (IL)-1 is one of the pivotal cytokines in initiating disease, and the body’s natural response, IL-1 receptor antagonist (IL-1Ra), has been shown conclusively to block its effects. In laboratory and animal studies inhibition of IL-1 by either antibodies to IL-1 or IL-1Ra proved beneficial to the outcome. To date, two large well-controlled studies in patients with RA led to the conclusion that IL-1Ra is clinically effective and that it slows progression of bone damage as measured radiographically. Being a specific, selective inhibitor of the IL-1 pathway, IL-1Ra could constitute an important new approach to treating patients with RA that significantly reduces the signs and symptoms of the disease, reduces joint destruction and up to now has proved safe and well tolerated.