New Strategies and Biological Agents in the Treatment of Autoimmune Inflammatory Diseases. Progress and Challenges

The last decade has seen profound improvements in the treatment and management of patients with autoimmune inflammatory diseases. This progress has been due, in large measures, to the development and application of new therapeutic agents that target selected molecules and cells. These agents are widely known as biological therapies. Success of biological therapies in the clinic and the development of new laboratory tests for early diagnosis brought with them new and progressive thinking on proactive disease management. Thus, treating patients with chronic inflammatory diseases at early stages with biological therapies and/or traditional disease modifying drugs are reducing disease severity and limiting damage. In addition to immeasurable health and economical benefits, successful application of biological therapies is providing new and direct insights into disease mechanisms superior to those previously provided by correlation studies. Such new insights, in turn, are providing new clues of further targets for treatment. However, this success has raised new challenges not least increased patient expectation. This is not a simple challenge considering the fact that not all patients with clinically similar manifestations respond to a given biological agent. In addition, lack of responses in some patients with similar clinical symptoms implies that alternative mechanisms of disease may be operating in different patient subsets. Therefore, much more work is still needed to understand disease mechanisms and identify new therapeutic targets.