• Biologic therapies for RA are protein-based drugs which target specific components of the immune system known to be of pathogenic relevance • Biologic therapeutics targeting tumor neurosis factor alpha (TNFα) have been successful in suppressing inflammation and markedly inhibiting the progression of structural damage; five anti-TNF agents are now available: adalimumab, certolizumab pegol, etanercept, golimumab, and infliximab • Biological TNFα inhibitors have greatest efficacy for improvement in symptoms and signs and prevention of structural damage when used in combination with...

• Biologic therapies for RA are protein-based drugs which target specific components of the immune system known to be of pathogenic relevance • Biologic therapeutics targeting tumor neurosis factor alpha (TNFα) have been successful in suppressing inflammation and markedly inhibiting the progression of structural damage; five anti-TNF agents are now available: adalimumab, certolizumab pegol, etanercept, golimumab, and infliximab • Biological TNFα inhibitors have greatest efficacy for improvement in symptoms and signs and prevention of structural damage when used in combination with methotrexate • Rituximab is a biologic agent that depletes B cells for use after failure of an anti-TNF biologic agent • Abatacept, which targets the co-stimulatory pathway of inflammation, is approved for use in many countries (but not in the UK) • Other biologic therapies directed against different immune targets have been licensed for use in RA or are in development but have not yet been approved by NICE • Several new, non-biologic agent approaches to immuno-modulatory therapy for RA are also in development.