Rheumatoid arthritis (RA) is the most common multisystem inflammatory autoimmune disease, affecting approximately 1% of the global population. RA is characterized by symmetrical polyarthritis, which is caused by chronic inflammation in the synovial membranes leading to cartilage and joint destruction. Early diagnosis and aggressive treatment are key if the damage caused by this disease is to be controlled. Our increasing understanding of the pathogenesis of RA has transformed the therapeutic options available for people with this disease. Tumor necrosis factor inhibitors–the first biologically-based immunotherapies ('biologics') for RA–were approved over a decade ago, altering the lives of some patients; however, there are still unmet needs. Some patients do not respond to these agents, while others respond but only partially; there are also issues relating to tolerability, safety, loss of efficacy and cost.

In this context, research has focused on alternative cellular and molecular targets for RA therapeutics, and is leading to the emergence of next-generation biologics. This Focus issue on the future of therapy for RA contains a specially commissioned lead Review on the current state-of-the-art therapeutic approaches for RA and a series of shorter Review articles that introduce some new molecules and cells identified by the leaders in this field as the next promising targets for RA.

An NPG library of relevant Reviews, Perspectives, Research Papers, Research Highlights, News pieces and commentaries is also provided.