Editorial

Do we really need five TNF antagonists? Or more insight into the use of existing options? There is little question that the therapy of RA has improved over the past two decades, with better control of disease activity, enhanced inhibition of structural damage and superior long-term outcomes. There is also little question that the availability of biologics, often combined with MTX, has been substantially responsible for this improvement. TNF inhibitors, the first biologics available for treatment of RA, remain the most widely used agents in this category, and five different TNF inhibitors are available in the USA and most of the rest of the world. However, little evidence exists that the availability of five different agents in this class has added substantially to the RA treatment para-digm. A careful look at the current state of RA therapy ca