Anti-cytokine antibodies for rheumatic diseases.

Improved knowledge regarding the pathogenetic mechanisms involved in autoimmune diseases has contributed to the development of biological therapies, with advances in cytokine research in particular revolutionizing the treatment of several autoimmune diseases. Anti-TNF agents are the most promising drugs for reducing symptoms, slowing or arresting joint damage, and preventing functional disability in patients with rheumatoid arthritis who fail to respond to standard disease-modifying antirheumatic drugs. Anti-TNF agents may also be useful in the treatment of other rare disorders, such as various forms of vasculitis, polymyositis and dermatomyositis. However, clinical trials of TNF inhibitors and inhibitors of the proinflammatory cytokines IL-1, IL-6, IL-12, IL-15, IL-17 and IL-23 demonstrated that the activity of such compounds is accompanied by a series of adverse events that needs to be addressed. This review describes the efficacy and adverse events associated with anti-cytokine treatments for autoimmune rheumatic diseases.