ADVANCES IN RHEUMATOID ARTHRITIS TREATMENT: EFFICACY AND SAFETY OF CONVENTIONAL AND BIOLOGIC DRUGS IN AN INTEGRATIVE REVIEW

Abstract

Rheumatoid arthritis is a chronic inflammatory autoimmune disease that requires sustained control of disease activity and monitoring of treatment-related risks. This study aimed to analyze the efficacy and safety of conventional and biological antirheumatic drugs while also considering targeted synthetic therapies. An integrative literature review with a qualitative, descriptive approach was conducted using original publications from 2022 to 2026 selected from PubMed, SciELO, and LILACS. Fourteen publications were examined, focusing on clinical response, remission, low disease activity, treatment persistence, intolerance, and adverse events. The results indicated that methotrexate remains central to treatment, either alone or in combination, although intolerance may compromise its continuation. Biological and targeted synthetic agents broaden treatment options after an inadequate response, but remission and treatment persistence tend to decline across successive treatment lines. Drug retention varied across mechanisms of action, while infections, intolerance, and loss of response were among the reasons for discontinuation. The review concludes that advances in rheumatoid arthritis pharmacotherapy depend on integrating efficacy, safety, and treatment continuity through individualized selection based on disease activity, previous treatments, comorbidities, and tolerability. Pharmaceutical and multidisciplinary follow-up is essential to monitor adverse reactions, support adherence, and guide treatment adjustments.