Biologics, a new weapon in the treatment of rheumatoid arthritis Modern medical concepts suggest that the goal of treatment for rheumatoid arthritis (hereafter referred to as rheumatoid arthritis) is to maximize the relief of joint swelling and pain, prevent joint deformity, and help maintain normal motor function. Drug therapy is a central part of the treatment plan for this disease. Existing therapeutic drugs are divided into three main categories – “symptomatic drugs” (anti-inflammatory and analgesic drugs), “curative drugs” (disease-modifying anti-rheumatic drugs represented by methotrexate), and “hormones” (glucocorticoids). With the development of modern medical science, on the basis of the traditional “cure” (chemically synthesized small-molecule drugs), a variety of biologic “cure” (genetically engineered synthetic large-molecule drugs) have been successfully developed in the past 20-30 years, which have significantly improved the prognosis of rheumatoid arthritis. The prognosis has been significantly improved. Let’s briefly review the history of the human race in the fight against Streptococcus suis. A German chemist named Hoffmann, who vowed to develop a drug to relieve his father’s pain because his father was suffering from P. aeruginosa, was inspired by the pain-relieving properties of willow bark extract (which has salicylic acid) and finally succeeded in synthesizing acetylsalicylic acid (i.e., aspirin) in 1896. This was the first anti-inflammatory and pain-relieving drug in the world capable of treating the wind-like pass. When his colleague Kendall succeeded in isolating the hormone (cortisone) from the adrenal cortex in 1949, he was eager to apply it to 14 patients, and the results were surprisingly good. For this outstanding contribution, Hench and Kendall won the Nobel Prize in 1950. However, because doctors at the time were not sufficiently aware of the adverse effects of glucocorticosteroids, it led to abuse at one time and resulted in notoriety. Still, modern medicine believes that the benefits far outweigh the disadvantages, as long as they are applied wisely. Methotrexate was developed in the 1940s and was initially used in the treatment of leukemia. It was found to be effective in the 1970s and was officially approved by the FDA in 1988 for the treatment of this disease. The drug is slow to work, taking 1-2 months to show a gradual effect, but only shows mild improvement in 70% of patients. If methotrexate is compared to a “rifle” for wind-like disease, then “biologics” for wind-like disease can be considered as “missiles”. These drugs, which were introduced in the 1990s, include the highly selective blockers of the pathogenic tumor necrosis factor (TNF) Ixepro or Enzyme, Classic, and Xumilor, and the highly selective blockers of the pathogenic interleukin-6 (IL-6) Yamiro. Their common feature is that they are all protein-based drugs, produced by genetic engineering technology, so they are called “biologics”, which are ineffective when taken orally and must be administered by injection. Compared to traditional “cures”, biologics are usually effective within a few days and are many times more potent than methotrexate, and can effectively prevent structural damage to the joints. The main side effect is a slightly increased risk of secondary infection, especially in patients with a history of tuberculosis who may experience a recurrence of tuberculosis with biologics. Its main disadvantage is its expensive price, which makes it difficult to be used universally in most patients. Pneumatoid arthritis is a chronic, persistent, progressive, and destructive arthritis that requires lifelong treatment. The most effective treatment option is the combination of biologics and methotrexate, which allows most patients to achieve clinical remission (essentially no progression of the disease) and live with the disease.