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Autoimmune rheumatic diseases: recent advances and current challenges

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Biological disease-modifying agents are transforming the treatment of autoimmune rheumatic diseases

Over the past decade, the advent of biological disease-modifying agents has led to transformational changes in the management of inflammatory joint diseases. This has been most obvious with advances in treatments for rheumatoid arthritis (RA). However, steady progress is also being made in treating lupus and other autoimmune rheumatic conditions. In this issue of the MJA, several articles discuss these developments along with current challenges.

For RA, we now have a broad suite of effective therapies with a number of new products and biosimilars in the pipeline. Jones and colleagues1 review the significant advances in our understanding of important cytokine pathways in RA, many of which are now targeted therapeutically. There is evidence for a window of opportunity in the first 6 months of disease, when therapies are both more effective and have a long term effect on disease, independent of subsequent treatment. Achieving this requires shared care between the general practitioner and rheumatologist. The expanded therapeutic options and new approaches have made disease remission a realistic goal. Current challenges in the management of RA include the lack of methods for efficiently targeting therapies to those most likely to benefit, as well as the optimal way to introduce biosimilars into…