The specific mechanisms that contribute to the development of rheumatoid arthritis are under intense investigation. Such research studies hold the promise of better treatments for rheumatoid arthritis in the future.
For example, only a few years ago, the role of tumor necrosis factor (TNF) in rheumatoid arthritis was unknown. Today, new disease-modifying antirheumatic drugs that inhibit TNF (including adalimumab, certolizumab, etanercept, golimumab and infliximab) have been studied and approved for use in the United States. These drugs now control the symptoms of rheumatoid arthritis for thousands of people.
It is likely that additional chemicals involved in the inflammation characteristic of rheumatoid arthritis will be identified. Drugs targeting these chemicals will then be developed and may prove useful. Recent studies suggest that a medication that targets B-cells, rituximab, is highly effective for rheumatoid arthritis. A B-cell is a type of white blood cell that produces antibodies, although its role in rheumatoid arthritis is uncertain. In 2006, rituximab was approved for the treatment of rheumatoid arthritis. Another recently approved drug, abatacept, inhibits the activation of T-cells (immune cells involved in recognizing foreign proteins to attack). Tocilizumab and tofacitinib are additional medications approved recently for rheumatoid arthritis. In addition, researchers are working to identify the gene or genes that cause or increase the risk of developing rheumatoid arthritis. Many experts are convinced that gene therapy and the ability to optimize treatment based on an individual's genetic makeup soon will become realities for this disorder.
Finally, dietary as well as complementary and alternative medicine therapies may begin to play a larger role in the treatment of rheumatoid arthritis when the results of ongoing studies become available.
Enrolling in a clinical trial of new treatments for rheumatoid arthritis may be an appealing option for anyone with this disease, especially when no treatment seems to be working well. If you are interested in participating in research in the disease, discuss it with your health-care provider.