The era of anti-cytokine treatment in rheumatology has just begun. The firs
t generation therapeutic agents, biological agents that block tumour necros
is factor a such as monoclonal antibodies or receptor Ig fusion proteins ar
e safe and effective, and so this has generated much interest in how to inc
rease the benefit or deliver it more cost effectively. This article provide
s a personal view of the coming trends in anti-cytokine treatment. Which of
these will be realised in the future will be of interest.