Taiwan experience with etanercept in juvenile rheumatoid arthritis.

A surge in demand in the field of therapy for chronic destructive arthritis has stimulated the development of new, more effective and less toxic antirheumatic drugs, such as cyclosporine and leflunomide. Although these agents produce significant improvement in disease control, their effects in prevention of joint destruction remain unsatisfactory. Under such circumstances, the emergence of so-called biologic agents offers hope for conventional drug-refractory destructive arthritis as well as for many other autoimmune disorders. Aside from significantly increased therapeutic efficacy, these biologic agents such as tumor necrosis factor (TNF) blockers, interleukin (IL)-1 receptor antagonist and the synthetic immunomodulatory agent CTLA4-Ig (soluble synthetic CTLA4 fusion protein) have much improved side effects profiles compared with conventional antirheumatic drugs like corticosteroids, cyclophosphamide and cyclosporine. These biologic agents are becoming more and more important as a means of stopping the destructive process of autoimmune joint disorders.