New and Emerging Therapies Related to Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by inflammation in synovial joints, leading progressively to pain, joint deformities, and diminished mobility. Current pharmacological management of RA includes nonsteroidal anti-inflammatory medications (NSAIDs), glucocorticoids (GCs), conventional disease-modifying anti-rheumatic drugs (DMARDs), and biologic DMARDs (bDMARDs), which primarily alleviate pain and inflammation. However, these agents are often associated with several side effects, such as immunosuppression, neurological complications, risk of developing multiple sclerosis, and lymphoma in certain patients. Recent advances have led to the development of new therapies that may offer greater effectiveness with fewer side effects. In this review, we highlight both recently explored therapies and therapies under investigation. The literature search was conducted using PubMed and Scopus, employing the names of specific therapies as keywords. Information on the ongoing and completed trials was obtained from the National Library of Medicine database. Promising new therapies include biosimilar-based infliximab and etanercept, mesenchymal stem cell therapy, Janus kinase (JAK) inhibitors, and plant-derived compounds such as mangiferin and cinnamic acid. Additional therapies currently under investigation involve ASITI-RA, macrophage repolarization, CAR-T cell therapy, extracellular vesicles, photobiomodulation, and nanomedicine. These emerging therapies are ushering in a more targeted, patient-specific approach, with improved therapeutic responses and fewer side effects, and are deviating from a generalized symptom-management approach.