EFFECTS OF BIOLOGIC THERAPIES ON SYMPTOMS IN PATIENTS WITH RHEUMATOID ARTHRITIS: A NARRATIVE REVIEW

Abstract

Introduction: Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease causing progressive joint destruction, pain, disability, and reduced quality of life. Many patients respond inadequately to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), necessitating more effective treatment strategies. Background: Biologic disease-modifying antirheumatic drugs (bDMARDs) and targeted synthetic therapies have transformed RA management by targeting inflammatory pathways such as tumor necrosis factor (TNF), interleukin-6 (IL-6), and Janus kinase (JAK) signaling. Methods: A narrative-systematic review of randomized clinical trials and observational studies was conducted to evaluate the efficacy and safety of biologic therapies in RA patients with inadequate response to csDMARDs. Outcomes included ACR20/50/70 response rates, Disease Activity Score in 28 joints (DAS28), remission rates, functional outcomes, and adverse events. Results: Biologic therapies significantly reduced disease activity and improved patient outcomes. TNF inhibitors combined with methotrexate achieved the most consistent efficacy, with ACR20, ACR50, and ACR70 responses reaching 78%, 57%, and 31%, respectively. Remission rates approached 40–50% in several studies. IL-6 inhibitors and JAK inhibitors provided rapid pain relief and functional improvement. Overall, remission or low disease activity was achieved in 30–60% of patients. Although biologic therapies increased the risk of adverse events, particularly infections, their safety profile remained acceptable with proper monitoring. Discussion: The findings demonstrate that biologic and targeted therapies represent a major advancement in RA treatment, particularly in patients resistant to conventional therapies. Differences in efficacy and safety profiles support individualized treatment selection, while methotrexate combination therapy may further enhance clinical response. Conclusion: Biologic therapies substantially improve disease control, physical function, and quality of life in RA patients. TNF inhibitors, IL-6 inhibitors, and JAK inhibitors remain central to modern RA management, although continued long-term safety monitoring and personalized therapeutic strategies are essential.