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New advances in interleukin 1 blockade for the treatment of rheumatoid arthritis

Joseph A Markenson

Rheumatoid arthritis is a chronic and progressive inflammatory disorder that causes marked joint destruction, significant work disability, functional declines, and premature mortality. It affects approximately 0.5 to 1% of the population in developed countries, with women being two-times more likely than men to be affected [1]. Even in the early stages, rheumatoid arthritis reduces quality of life, with more than 50% of patients reporting its impact on daily, leisure and social activities [2]. As the disease progresses, work disability becomes increasingly more common, with aproximately 40% being disabled after 10 years’ follow-up [3,4].Disability is correlated with disease duration, but it shows an even stronger correlation with radiographic measures of joint damage, particularly in patients who have had the disease for at least 5 years [5]. In addition to causing significant morbidity, rheumatoid arthritis has a substantial economic impact on patients, as well as society. In the USA, total annual costs have been estimated at up to US$32 billion (1998 dollars) or more than US$20,000 per patient [6]. Direct medical costs, primarily due to hospitalization, account for approximately a third of total costs, whereas indirect costs principally attributed to work disability account for the rest.