Comment je traite ... une polyarthrite rhumatoïde. L'avènement d'une nouvelle ère thérapeutique: les anticorps anti-TNF-alpha

Rheumatoid arthritis (RA) is the most frequent autoimmune inflammatory
arthropathy. Chronic synovial inflammation usually results in cartilage
destruction, bone erosion and subsequent joint deformities with impaired physical
function. These consequences are more or less delayed by standard
disease-modifying antirheumatic drugs (DMARDs). A better knowledge of the basic
mechanisms of the disease and new biomolecular tools led to the development of
novel biological agents including TNF alpha blockers. TNF alpha is a key
inflammatory cytokine that plays a critically important role in the pathogenesis
of RA. TNF alpha blockers brought dramatic improvements in efficacy of RA
treatment. Here we will review the pathophysiological elements of RA wich explain
the therapeutic efficacy of these TNF alpha blockers and we will describe in
details the molecules, Remicade (Infliximab) and Enbrel (Etanercept), wich will
be very soon used in daily practice in Belgium.