Monoclonal Antibodies in Rheumatoid Arthritis

Marc Cohen; Mohammed A Omair; Edward C Keystone


Int J Clin Rheumatol. 2013;8(5):541-556. 

In This Article

Abstract and Introduction


Monoclonal antibodies are a group of complex and effective biologic agents used in the treatment of rheumatoid arthritis and other immune-mediated inflammatory diseases. They now represent an important series of options in the treatment of rheumatoid arthritis. In this review, we discuss the efficacy and safety of these agents. In addition, information regarding upcoming monoclonal agents and biosimilars is presented.


The treatment of rheumatoid arthritis (RA) has dramatically changed in the last decade since the introduction of the biological agents. Achieving remission in the clinical, functional and radiographic domains has become an achievable target.[1] Clinical studies involving biologic agents in RA have been essential to the recent progress in RA treatment. Monoclonal antibodies directed against the pathogenic cytokine and cellular elements within the RA synovium have been the most common form of biologic developed. Monoclonal antibodies (mAbs) are monospecific antibodies that are produced by immune cells that are all clones of a unique parent cell. Initial studies using mAbs in RA utilized anti-CD4, anti-CD7 and CAMPATH-1H as targets, with varying degrees of efficacy and with significant safety concerns.[2–10] Over the last decade, however, directed against a number of different target molecules mAbs have received US FDA approval for the treatment of RA. These are directed against TNF-α, CD20-positive B cells, IL-1 and IL-6. Other biological agents approved for the treatment of RA are not monoclonal antibodies but fusion proteins and include etanercept and abatacept.