Stairway to Heaven: Do head-to-head Trials Indicate a Need for Definite Criteria for Choosing Biologic Drugs in Rheumatoid Arthritis?

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dc.authoridKOBAK, SENOL/0000-0001-8270-640X
dc.contributor.authorKobak, Senol
dc.date.accessioned2024-05-19T14:46:32Z
dc.date.available2024-05-19T14:46:32Z
dc.date.issued2023
dc.departmentİstinye Üniversitesien_US
dc.description.abstractRheumatoid arthritis (RA) is a chronic disease characterized by joint and systemic involvement that develops with different pathogenetic mechanisms. Treatment of the disease is undertaken with disease-modifying anti-rheumatic drugs (DMARDs). The mechanisms of action of conventional DMARDs generally are based on the inhibition of T and B-cells in the immune system. In recent years, biologic and targeted smart molecules have been used in the treatment of RA. Targeting different cytokines and inflammatory pathways, these drugs have ushered in a new era in RA treatment. The efficacy of these drugs has been demonstrated in many studies; and in the post-marketing period, that is, as the patients who use them say, they are like a stairway to heaven. However, as every road to heaven is challenging and thorny, the efficacy and reliability of these drugs and whether any one of them is superior to the others, remains a matter of debate. However, the use of biologic drugs with or without cDMARDs, the preference for original vs. biosimilar molecules, and discontinuation of the drugs after achieving sustained remission are other questions that need to be explored. When it comes to the choice of biological drugs by rheumatologists, it is not yet clear on which criteria they base their choices on. Due to the limited comparative studies of these biological drugs, the subjective criteria of the physician gains importance. The selection of these drugs, however, should be based on objective criteria such as efficacy, safety, superiority over each other, and cost. In other words, the determinant of the path to heaven should be based on objective criteria and recommendations according to the scientific data generated by controlled-prospective studies, not on the initiative of a single physician. In this review, a head-to-head comparison of biological drugs used in the treatment of RA, their efficacy, safety, and which are superior are discussed in light of recent literature data.en_US
dc.identifier.doi10.2174/1573397119666230427112617
dc.identifier.endpage419en_US
dc.identifier.issn1573-3971
dc.identifier.issn1875-6360
dc.identifier.issue4en_US
dc.identifier.pmid37102482en_US
dc.identifier.scopus2-s2.0-85168804970en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.startpage408en_US
dc.identifier.urihttps://doi.org10.2174/1573397119666230427112617
dc.identifier.urihttps://hdl.handle.net/20.500.12713/5544
dc.identifier.volume19en_US
dc.identifier.wosWOS:001089169600005en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.language.isoenen_US
dc.publisherBentham Science Publ Ltden_US
dc.relation.ispartofCurrent Rheumatology Reviewsen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.snmz20240519_kaen_US
dc.subjectRheumatoid Arthritisen_US
dc.subjectBiologicsen_US
dc.subjectHead-To-Headen_US
dc.subjectCriteriaen_US
dc.subjectDmardsen_US
dc.subjectDiseaseen_US
dc.titleStairway to Heaven: Do head-to-head Trials Indicate a Need for Definite Criteria for Choosing Biologic Drugs in Rheumatoid Arthritis?en_US
dc.typeReview Articleen_US

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