The role of current strategies in the future treatment of rheumatoid arthritis

Rheumatoid arthritis (RA) is a serious, chronic, debilitating disease for w hich no cure is available. Therapeutic aims for patients with RA are to all eviate symptoms, slow disease progression and optimize quality of life. In recent years, measures to achieve these goals have changed, and the develop ment of new drugs will probably result in new treatment regimens. Two drugs with an extensive record of clinical experience are methotrexate and cyclo sporin. Methotrexate is widely used because of its efficacy and high therap y retention rate. Both drugs have been shown to slow the progression of RA, but not without side-effects that sometimes preclude their use. As neither drug generally induces remission, improved treatments are needed. Combinat ion therapy using drugs with different mechanisms of action is beginning to be evaluated, as are biological response modifiers targeted to specific me diators of the immune response. The future treatment of RA should provide m ore effective relief with fewer side-effects.