SYSTEMATIC REVIEW: ARE BIOLOGICAL THERAPIES MORE EFFECTIVE THAN NON-BIOLOGICAL THERAPIES IN TREATING PATIENTS WITH REFRACTORY RHEUMATOID ARTHRITIS?

Abstract

ABSTRACT: The study aimed to systematically review the efficacy and safety of biological compared to non-biological therapies in the management of methotrexate (MTX)-refractory rheumatoid arthritis (RA). A comprehensive analysis of articles published between 2010 and 2023 in databases such as PubMed and Cochrane Library was conducted, covering systematic reviews, meta-analyses and randomized clinical trials that addressed the effectiveness of biological and non-biological treatments in patients with refractory RA. The results showed that biological therapies, such as TNF-α inhibitors and monoclonal antibodies, were superior to non-biological therapies in clinical response rates (ACR20, ACR50, ACR70), inflammation control and quality of life. However, challenges include adverse events such as respiratory infections and their limited effectiveness in severe cases. It was concluded that biological therapies should be prioritized for patients refractory to MTX, with strict monitoring to minimize risks. Future studies should explore therapeutic combinations and personalized strategies based on patients' immunological and pharmacogenetic profiles, optimizing clinical outcomes for multidrug-resistant subgroups.

Keywords: Rheumatoid Arthritis. Biological therapy. Refractory disease.