BIOLOGIC THERAPY IN INFLAMMATORY AND IMMUNOMEDIATED ARTHRITIS: SAFETY PROFILE

The increasing insights into the pathogenetic mechanisms of inflammatory autoimmune arthritis and the development of innovative systems of industrial production have led to discover molecules which are targeted at molecules involved in the mechanisms of the immune system and that have been introduced in clinical practice to provide an alternative to the existing treatment methods of disease-modifying anti-rheumatic drugs and other immunosuppressive medications. For this reason, such drugs are currently known as "biological drugs" and include molecules that induce the immunosuppression acting on several immune pathways. However, though the biological drugs have been employed from more than a decade, there still exist some drawbacks of their use, including the inconvenience of intravenous administration, the high costs, and adverse events associated with them. This review provides an update on the correct use and current therapeutic indications of such drugs, including some of the new biologic therapies that will be soon available for the clinical use, focusing on these biological drugs: tumor necrosis factor (TNF) inhibitors (adalimumab, certolizumab-pegol, etanercept, golimumab and infliximab); the T cell co-stimulation inhibitor, abatacept; the anti-CD20 receptor monoclonal B cell agent, rituximab; the IL-6 receptor-blocking monoclonal antibody, tocilizumab; the IL-1-inhibitor, anakinra; the IL-17-pathway inhibitors (ustekinumab, secukinumab, brodalumab).