Biologicals and how they revolutionized rheumatology
About one and a half decades ago, biological therapies have started to challenge our therapeutic options in rheumatology. Until the late 1990s, the rheumatologist’s armamentarium consisted mainly of methotrexate and other disease-modifying drugs (DMARDs) like sulfasalazine,d-penicillamine, gold and cyclosporine as well as medium to high doses of glucocorticoids and non-steroidal anti-rheumatic drugs (NSAIDs). Although many patients could be treated sufficiently, a noteworthy proportion of them still suffered from rapidly progressing disease despite receiving conventional immunosuppressive drugs. Moreover, these patients often developed several side effects due to the high-dose glucocorticoid and NSAID intake associated with increased morbidity and mortality.