MicroRNA Regulation in Rheumatoid Arthritis: Improving Tocilizumab-Based Treatment

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterised by persistent joint inflammation, pain, swelling, and progressive joint damage. miRNAs, small non-coding RNAs, play critical roles in immune regulation, and their dysregulation contributes to RA development. miRNAs are promising therapeutic targets in RA due to their broad effects and stage-specific regulatory roles. Tocilizumab (TCZ), a biological DMARD targeting the IL-6 receptor, has shown good clinical outcomes and plays a role in modulating miRNA expression, offering new insights into RA pathogenesis and treatment response. Recent studies suggest that miRNA-based therapies could modulate miRNA profiles to reduce inflammation and tissue damage. This paper explores TCZ’s role in miRNA regulation in RA, focusing on the modulation of miR-146a-5p and miR-150-5p and their effects on angiogenesis and inflammation. However, gaps remain in understanding the mechanisms through which miRNAs influence RA outcomes, the optimal delivery methods for miRNA therapies, and the long-term effects of TCZ on miRNA profiles. Further research is needed to optimize miRNA-based therapies, particularly in combination with TCZ and other conventional DMARDs, to enhance efficacy in RA treatment.