Efficacy of new biologics on bone destruction in rheumatoid arthritis

Rheumatoid arthritis (RA) is a representative bone disease. TNF-alpha plays a pivotal role in the pathological processes of RA, leading to cartilage and bone destruction. Although biologics targeting TNF have brought about a marked reduction of progression of bone destruction, the rate of remission induction is about 30% and the rest of the patients require alternative biologics such as B cell targeting (chimeric anti-CD20 antibody : rituximab) or T cell targeting (CTLA [cytotoxic T-lymphocyte antigen]-4-Igfusion protein : abatacept) therapies. To date, the efficacy of these new biologics on the disease activity and bone destruction was confirmed by randomized control trials. Then abatacept and rituximab were recommended for the treatment of the patients who do not respond adequately to TNF inhibitors.