Rheumatoid arthritis pathophysiology: update on emerging cytokine and cytokine-associated cell targets

Rheumatology doi:10.1093/rheumatology/ket414

Despite biologic therapies greatly improving the treatment of rheumatoid arthritis, many patients do not respond to current treatments or do not maintain response to these treatments. This review covers the evidence for the newly discovered role of Th17 cells, IL-12 and IL-17 family of cytokines in the pathogenesis of RA as well as the development of new therapies targeting these cytokines. With current biologics targeting cytokines such as TNF, IL-1ß and IL-6, the discovery of the Th17 subset of cells and subsequent implication of proinflammatory IL-12 and IL-17 families have provided novel therapeutic targets. The members of these families have been shown to be elevated in the joints and blood samples of RA patients and remain elevated in those patients who do not respond to biologic treatment.Furst and Emery further provide an overview of results from ongoing and completed clinical trials of the therapeutics being developed.