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25 years of biologic DMARDs in rheumatology

Nature Reviews Rheumatology volume 19, pages 761–766 (2023)Cite this article

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2023 marks 25 years since the approval of the first biologic drug in rheumatology. In this Viewpoint, five rheumatology researchers discuss how biologic therapy has transformed clinical practice, reflecting on their own experience, past and current challenges and what the future might hold for biologic drugs.

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Fig. 1: Approved TNF inhibitors in 2023.

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Acknowledgements

R.N.M. thanks the research fellows, colleagues, clinicians, nurses and patients who provided essential support in the research on TNF inhibition and the clinical trials project.

Author information

Authors and Affiliations

  1. Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK

    Marc Feldmann

  2. Imperial College London, London, UK

    Ravinder N. Maini

  3. Rheumatology Unit, Internal Medicine Service, Hospital Italiano de Buenos Aires, and Instituto Universitario, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Enrique R. Soriano

  4. Division of Immunology and Rheumatology, Stanford University, Palo Alto, CA, USA

    Vibeke Strand

  5. Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan

    Tsutomu Takeuchi

  6. Saitama Medical School, Saitama, Japan

    Tsutomu Takeuchi

Authors
  1. Marc Feldmann
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  2. Ravinder N. Maini
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  3. Enrique R. Soriano
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  4. Vibeke Strand
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  5. Tsutomu Takeuchi
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Contributions

Marc Feldmann: Marc Feldmann is an emeritus professor at the Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK. He trained in medicine in Melbourne, and subsequently attained a PhD in immunology at Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia. Together with Ravinder Maini, they defined and validated TNF as a therapeutic target in rheumatoid arthritis, for which they have received multiple prestigious awards, including the Lasker clinical award.

Ravinder Maini: Ravinder Maini was head of the Kennedy Institute of Rheumatology, and is now an emeritus professor at Imperial College, London, UK. His laboratory and clinical research was principally focused on the role of cytokines in rheumatoid arthritis. Together with Marc Feldmann, he had a pivotal role in advancing anti-TNF therapy from initial laboratory research to successful clinical implementation in the 1990s.

Enrique Soriano: Enrique Soriano is an associate professor at the University Institute Italian Hospital and former head and current staff at the Rheumatology Section, Italian Hospital in Buenos Aires, Argentina. He has been president of PANLAR and the Argentine Society of Rheumatology. His research interest in rheumatology focuses on the epidemiology of rheumatic diseases, spondyloarthritis and rheumatoid arthritis.

Vibeke Strand: Vibeke Strand is an adjunct clinical professor in the Division of Immunology and Rheumatology at Stanford University School of Medicine, CA, USA. Since 1991, she has led a consulting practice offering clinical research and regulatory strategy expertise to pharmaceutical and biotech companies. She is a fellow of the American College of Physicians, Master of the ACR and member of the Cosmos Club.

Tsutomu Takeuchi: Tsutomu Takeuchi is an emeritus professor and a specially appointed professor in the Division of Rheumatology, Department of Internal Medicine, Keio University, Japan. He is now appointed as the president of Saitama Medical University. He is the immediate past president of the Japan College of Rheumatology and president-elect of APLAR. His research interest is the pathogenesis and targeted treatment of systemic rheumatic diseases such as rheumatoid arthritis.

Corresponding authors

Correspondence to Marc Feldmann, Ravinder N. Maini, Enrique R. Soriano, Vibeke Strand or Tsutomu Takeuchi.

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Competing interests

R.N.M. declares that, as a co-inventor of anti-TNF therapy, he has received royalties from the Kennedy Trust for Rheumatology Research who owned, now expired, patents on anti-TNF therapy. M.F. declares that, as a co-inventor of anti-TNF therapy, he has received royalties in the past for patents, now expired. He is currently involved in a small biotech (Enosi Therapeutics) that is trying to develop an anti-TNFR1 therapeutic. T.T. declares that he has received grants from AbbVie, Asahikasei, AYUMI, Chugai and Mitsubishi-Tanabe, and honoraria from AbbVie, Asahikasei, Astellas, Bristol-Myers Squibb, Chugai., Daiichi Sankyo., Eisai, Janssen K.K., Mitsubishi-Tanabe and Pfizer Japan. E.R.S. declares that he has participated in advisory boards, given conferences and/or received grants from Abbvie, Amgen, Celtrion, Bristol-Myers Squibb, Genzyme, Glaxo, Janssen, Lilly, Novartis, Montpellier, Pfizer, Roche, Sandoz and UCB. V.S. declares that she has been a consultant for Abbvie, Alpine Immune Sciences, Alumis, Amgen Corporation, Aria, AstraZeneca,Atom Biosciences, Bayer, BMS, Boehringer Ingelheim, Celltrion, Ermium, Genentech/Roche, Gilead, GSK, Horizon, Inmedix, Janssen, Kiniksa, Lilly, Merck, MiMedx, Novartis, Omeros, Pfizer,R-Pharma, RAPT, Regeneron, Samsung, Sandoz, Sanofi, Scipher, Setpoint, Sorrento, Spherix and Urica.

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Feldmann, M., Maini, R.N., Soriano, E.R. et al. 25 years of biologic DMARDs in rheumatology. Nat Rev Rheumatol 19, 761–766 (2023). https://doi.org/10.1038/s41584-023-01036-x

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