“... my personal research interests were always in the elucidation of the pathways leading to autoimmune diseases and translation of these insights to the bedside...” (View a photo of Smolen's team. Günter Steiner is in the center with the blue jacket.)

This paper reviews the pathogenesis of rheumatoid arthritis, its traditional and most recently approved therapies, as well as drug agents currently in trial and potential future therapeutics.

It describes not only the latest pathogenic insights and novel therapies, but also the limitations of current treatment approaches to rheumatoid arthritis.

Recent years have seen considerable advances in the understanding of both clinical and basic-research aspects of rheumatoid arthritis. Clinical progress has come from better recognition of the disease’s natural history, the development and validation of outcome measures for clinical trials and, consequently, innovative trial designs, which have allowed us to better judge the degrees of therapeutic successes, as well as the limitations of current treatment modalities. In parallel efforts, basic research has provided clues to pathogenic events and to advances in biotechnology that have facilitated the development of new classes of therapeutics, such as TNF-blocking agents. In this paper, we summarize the fruits of these advances: innovative approaches to the use of existing, traditional disease- modifying anti-rheumatic drugs, novel agents approved only very recently, and further avenues that are under current investigation or are of more distant promise.

As an immunologist, internist, and rheumatologist, from my earliest days in research until today, my personal research interests were always in the elucidation of the pathways leading to autoimmune diseases and translation of these insights to the patient. This is likewise the major focus of the entire team at the Division of Rheumatology at the Medical University of Vienna. The co-author of this paper, Günter Steiner, Ph.D., is a biochemist and molecular biologist who fills a central role in our laboratory and whose efforts, for many years, have also been devoted to translational research in the field of rheumatology and autoimmunity.