Rheumatoid arthritis. New disease-modifying and anti-inflammatory drugs.

Treatment options for rheumatoid arthritis (RA) are expanding as research has provided a more complete understanding of the pathophysiology of the disease. Three disease-modifying agents approved in the last 18 months for early intervention in RA are etanercept, leflunomide, and infliximab. For the relief of the signs and symptoms of RA, the new selective cyclooxygenase-2 (COX-2) inhibitors are joining the available nonsteroidal anti-inflammatory drugs. One COX-2 inhibitor is approved for use in RA, and another is under investigation for that indication. As a class, the COX-2 inhibitors offer efficacy similar to traditional NSAIDs but with less GI and platelet toxicity.