Madenidou, Anastasia-Vasiliki; Ciurtin, Coziana; (2022) Monoclonal Antibodies in Rheumatology. In: el Baghdady, Assem and Peter, Stonier, (eds.) Monoclonal Antibodies: History, Mechanism and Application. Euromed Communications: Hampshire, UK.

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Abstract

The pathogenesis of autoimmune rheumatic diseases (ARDs) involves the interaction and activation of immune cells with the release of multiple inflammatory cytokines such as tumour necrosis factor α (TNF -α) and interleukins. The advances in molecular biology enabled the development of pivotal molecules called monoclonal antibodies (mAbs), which target various mechanisms of disease pathogenesis. The advent of mAbs has revolutionised the management of ARDs, as these therapeutic agents have shown benefits in controlling the symptoms of some patients who lost response or had side-effects to conventional disease modifying antirheumatic drugs (cDMARDs). This chapter reviews the use of mAbs in ARDs. We will focus on the type, mode of action, clinical efficacy and safety profile of mAbs, with particular emphasis on TNFα, interleukin 6 (IL6) interleukin 17/23 (IL17/23) axis and T cell co-stimulatory blockade, as well as and B cell depletion therapies. Additionally, we will discuss the emerging biosimilars which can potentially have a positive impact on the socioeconomic burden of ARDs.

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