MONOCLONAL-ANTIBODY THERAPY OF INFLAMMATORY RHEUMATIC DISEASES

The recognition that certain monoclonal antibodies have immunosuppress ive properties led to the therapeutic application in autoimmune rheuma tic diseases, rheumatoid arthritis in particular, The therapeutic pote ntial of monoclonal antibodies directed against cell surface antigens mainly present on T-cells has been suggested by open trials in rheumat oid arthritis but the results of controlled studies are disappointing. Open intervention studies with monoclonal antibodies directed at othe r antigens relevant for the rheumatoid inflammation such as the interc ellular adhesion molecule ICAM-1 or the cytokines IL-6 and TNF alpha, provided encouraging clinical improvements. The impressive potential o f anti-TNF alpha which was already illustrated by the immediate suppre ssion of the acute phase response in open studies could be confirmed b y a recently completed controlled trial. The present overview summariz es the available information on the results of these treatment modalit ies and discusses the possibilities of monoclonal antibodies as a long term treatment for rheumatic diseases.