The main challenge in the development of new modalities for the treatm
ent of rheumatoid arthritis is to enhance the specificity while reduci
ng the adverse side-effects of therapeutics. Biotechnology provides a
variety of reagents, such as monoclonal antibodies, recombinant cytoki
nes, cytokine antagonists, and small peptides, with the potential to i
nterfere with selected stages of the disease process in a highly speci
fic manner. In addition, several new therapeutic approaches have emerg
ed as a result of extensive research with animal models oi disease, in
cluding T-cell vaccination and bone marrow transplantation. This artic
le discusses current insights into the pathogenesis of rheumatic disea
ses, focusing on rheumatoid arthritis. A number of new therapeutic mod
alities for rheumatoid arthritis, in particular those acting on the im
mune system, are discussed. Because it is not possible to provide a co
mplete overview of all the developments in the field in limited space,
a selection of strategies and modalities which are representative of
the broad variety of immunotherapeutic approaches currently used are h
ighlighted.