Background: Biologic drugs, introduced in clinical practice almost twenty years ago, represent
nowadays a prominent treatment option in patients with chronic inflammatory arthritis, such as
Rheumatoid Arthritis, Psoriatic Arthritis and Spondyloarthritis, that include ankylosing spondylitis and
non-radiographic axial spondyloarthritis.
Methods: Several compounds targeting different pathways have been marketed and approved for the
treatment of inflammatory arthritis, with a significant impact on the clinical outcomes and the natural
history of the diseases.
Results: There are currently seven classes of biologics that are available for the treatment of inflammatory
arthritis, each inhibiting a different aspect of the immune-driven inflammatory pathway.
• Tumor Necrosis Factor (TNF) inhibitors (infliximab, adalimumab, etanercept, golimumab and certolizumab
• Interleukin-1 (IL-1) receptor antagonists (anakinra);
• Interleukin-6 (IL-6) inhibition (tocilizumab);
• Interleukin-12/23 (IL23) inhibition (ustekinumab);
• Interleukin-17 (IL-17) inhibition (secukinumab);
• B-cell inhibition (anti-CD20, rituximab);
• T-cell costimulation inhibition (anti-CTLA-4, abatacept).
Conclusion: In this review, we will focus on the role of biologic drugs in the treatment strategies for