NEW INSIGHTS INTO THE PHARMACOLOGICAL MANAGEMENT OF RHEUMATOID ARTHRITIS

Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disease characterized by synovial inflammation and progressive joint destruction which significantly impairs patients’ quality of life and generates substantial socioeconomic costs. Conventional disease-modifying antirheumatic drugs (DMARDs) such as methotrexate are the cornerstone of RA therapy, particularly for early or mild forms of disease. The newer, biologic DMARDs are a more advanced therapeutic option when conventional DMARDs are not sufficiently effective, or they cause important adverse effects. Targeted synthetic DMARDs are also a recently authorized class of drugs which have the advantage of oral administration. The aim of this review is to provide an overview of rheumatoid arthritis’ pharmacological management, focusing on the most important properties of conventional, biologic and targeted synthetic DMARDs and presenting also the current international treatment guidelines. Natural compounds which could be used as adjuvants in the therapy of RA are also detailed.