Rheumatoid arthritis is a chronic inflammatory disease characterized by symmetrical polyarthritis and extra-articular features. Current management involves relieving symptoms with NSAIDs or COX-2 inhibitors while also using disease-modifying antirheumatic drugs to slow disease progression. For patients with moderate to severe active disease despite treatment, biologic response modifiers such as TNF-α inhibitors can be used and have been shown to reduce inflammation, joint damage, and improve hematological markers. Proper screening and monitoring is required when using biologics due to potential infection and malignancy risks.

1. Rheumatoid Arthritis Carole Callaghan Principal Pharmacist NHS Lothian

8. Pathology

9. Pathology

12. Signs

28. TNF  -  Mode of Action Activated Macrophage TNF Target Cell Signal sTNFR

29. Anti-TNF Biologics - Mode of Action Activated Activated Macrophage Target Target Cell Cell Signal Signal sTNFR sTNFR TNF TNF TNFR TNFR

32. B Cell Involvement in the Pathogenesis of RA

33. Biologic Pathways

35. Immunogenecity

44. Abatacept

46. Tocilizumab