• BALJIT K. Department of Pharmacology, CT Institute of Pharmaceutical Sciences, Jalandhar
  • QADRIE Z. L. Department of Pharmacology, CT Institute of Pharmaceutical Sciences, Jalandhar
  • AMIT B. Department of Pharmacology, CT Institute of Pharmaceutical Sciences, Jalandhar
  • GAUTAM S. P. Department of Pharmacology, CT Institute of Pharmaceutical Sciences, Jalandhar


There are distinct Rheumatic disorders, still Rheumatoid arthritis (RA) is believed to be very prevailing. RA is an empathic disorder described over integral redness, constant inflammation, and the existence of auto-antibodies. In RA, inflammation in joints, loss of motion of joint stiffness, joint tenderness are most common in patients. Deformity of joints can be prevented by early diagnosis and treatment. The extremity of the disease can be reduced by combining the drugs and improved weight more profiled than single medication. Treat-to-target progress results in a superior-conclusion in RA, and the ACR, EULAR, and other specialized systems have supported treat-to-target as a basic curative strategy for RA. The novel methods used in RA have upgraded the development of the disorder and maximum people helpful in cancellation of clinical manifestations if the identification of disorder takes place before time. This review article is written after studying most of the journal’s articles, which were published between 1997-2019.

Keywords: Rheumatoid arthritis, Pathology, Autoimmune inflammation, Auto-antibodies


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1. Pan T, Cheng T, Jia Y, Li P, Li F. Anti-rheumatoid arthritis effects of traditional Chinese herb couple in adjuvant-induced arthritis in rats. J Ethnopharmacol 2017;205:1-7.
2. Smolen JS, Aletaha D, Barton A, Burmester GR, Emery P, Firestein A GS, et al. Rheumatoid arthritis. Nat Rev Dis Primers 2018;4:18001.
3. Abbasi M, Mousavi M. Strategies toward rheumatoid arthritis therapy; the old and the new. J Cell Physiol 2019;234:10018-31.
4. Wehr P, Purvis H, Law SC, Thomas R. Dendritic cells, T cells and their interaction in rheumatoid arthritis. Clin Exp Immunol 2019;196:12-27.
5. Van der Woude D, van der Helm-van Mil AHM. Update on the epidemiology, risk factors, and disease outcomes of rheumatoid arthritis. Best Pract Res Clin Rheumatol 2018;32:174-87.
6. Bourne AM, Johnston RV, Cyril S, Hill, C Hiller, SJ Kamper, et al. Scoping review of priority setting of research topics for musculoskeletal conditions. Br Med J Open 2018;8:e023962.
7. Okada Y, Eyre S, Suzuki A, Kochi Y, Yamamoto K. Genetics of rheumatoid arthritis: 2018 status. Ann Rheum Dis 2018;10:1-8.
8. Viatte S, Barton A. Enetics of rheumatoid arthritis susceptibility, severity, and treatment response. Semin Immunopathol 2017;39:395-408.
9. Frank Bertoncelj M, Klein K, Gay S. Interplay between genetic and epigenetic mechanisms in rheumatoid arthritis. Epigenomics 2017;9:493-504.
10. Belbasis L, Dosis V, Evangelou E. Elucidating the environmental risk factors for rheumatic diseases: an umbrella review of meta-analyses. Int J Rheum Dis 2018;21:1514-24.
11. Jalil SF, Arshad M, Bhatti A, Ahmad J, Akbar F, Ali S. Rheumatoid arthritis: what have we learned about the causing factors? Pak J Pharm Sci 2016;29:629-45.
12. Bernstein, Elana J, Mandl LA. Changing incidence of orthopedic surgery in rheumatic disease: contributing factors. Curr Rheumatol Rep 2013;15:365-78.
13. Ometto F, Botsios C, Raffeiner B. Methods used to assess remission and low disease activity in rheumatoid arthritis. Autoimmun Rev 2010;9:161-4.
14. Forestier J. Heberden oration, 1962: three french pioneers in rheumatology. Ann Rheum Dis 1963;22:63-70.
15. Appelboom T, Ehrlich GE. Historical note: the concept of gout in 1880. Arthritis Rheum 1998;41:1511-2.
16. Copeman WSC, Berkeley MD, Angeles Los FRCP. A short history of gout and the rheumatoid arthritis. University of California Press 1964;7:145-236.
17. Aceves Avila FJ, Medina F, Fraga A. The antiquity of rheumatoid arthritis: a reappraisal. J Rheumatol 2001;28:751-7.
18. Rantapaa. Dahlqvist, Solbritt. Antibodies against cyclic citrullinated peptide and IgA rheumatoid factor predict the development of rheumatoid arthritis. Arthritis Rheum 2003;48:2741-9.
19. Yang M, Feng X, Ding J, Chang F, Chen X. Nanotherapeutics relieve rheumatoid arthritis. J Controlled Release 2017;252:108-24.
20. McInnes IB, Schett G. Pathogenetic insights from the treatment of rheumatoid arthritis. Lancet 2017;389:2328-37.
21. Firestein GS, McInnes IB. Immunopathogenesis of rheumatoid arthritis. Immunity 2017;46:183-96.
22. Semerano L, Decker P, Clavel G, Boissier MC. Developments with investigational janus kinase inhibitors for rheumatoid arthritis. Expert Opin Investig Drugs 2016;25:1355-9.
23. Saag KG. Low-dose corticosteroid therapy in rheumatoid arthritis: balancing the evidence. Am J Med 1997;103:31S–9.
24. Movahedi M, Beauchamp ME. Risk of incident diabetes mellitus associated with the dosage and duration of oral glucocorticoid therapy in patients with rheumatoid arthritis. Arthritis Rheumatol 2016;68:1089-98.
25. Aggarwal R, Liao K, Nair R, Ringold S, Costenbader KH. Anti-citrullinated peptide antibody assays and their role in the diagnosis of rheumatoid arthritis. Arthritis Rheum 2009;61:1472-83.
26. Pandya DT, Patel GC, Ambegaokar PP, Vyas ND. Comorbidity of cardiovascular diseases and rheumatoid arthritis. Asian J Pharm Clin Res 2017;10:72-7.
27. Kroot EJ, de Jong BA, van Leeuwen MA. The prognostic value of anti-cyclic citrullinated peptide antibody in patients with recent-onset rheumatoid arthritis. Arthritis Rheum 2000;43:1831-5.
28. Colebatch AN, Edwards CJ. EULAR recommendations for the use of imaging of the joints in the clinical management of rheumatoid arthritis. Ann Rheum Dis 2013;72:804-14.
29. Aletaha D, Neogi T. Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 2010;62:2569-81.
30. Murata K, Yoshitomi H, Tanida S. Plasma and synovial fluid microRNAs as potential international biomarkers of rheumatoid arthritis and osteoarthritis. Arthritis Res Ther 2010;12:R86.
31. Gavrila BI, Ciofu C, Stoica V. Biomarkers in rheumatoid arthritis, what is new? J Med Life 2016;9:144-8.
32. Mc Ardle A, Flatley B, Pennington SR, FitzGerald O. Early biomarkers of joint damage in rheumatoid and psoriatic arthritis. Arthritis Res Ther 2015;17:141.
33. Srikantiah C. Current studies of biomarkers for the early diagnosis of rheumatoid arthritis. Curr Biomarker Findings 2014;4:107-19.
34. Golan I. Disease-specific biomarkers for early diagnosis of rheumatoid arthritis and other chronic arthritic conditions. MOJ Immunol 2016;3:83-5.
35. Ferreira JF, Ahmed Mohamed AA, Emery P. Glucocorticoids and rheumatoid arthritis. Rheum Dis Clin North Am 2016;42:33-7.
36. McDonough AK, Curtis JR, Saag KG. The epidemiology of glucocorticoid-associated adverse events. Curr Opin Rheumatol 2008;20:131-7.
37. Saag KG, Koehnke R. Low dose long-term corticosteroid therapy in rheumatoid arthritis: an analysis of serious adverse events. Am J Med 1994;96:115-23.
38. Nicolaides NC, Galata Z, Kino T, Chrousos GP, Charmandari E. The human glucocorticoid receptor: molecular basis of biologic function. Steroids 2010;75:1-12.
39. Vandevyver S, Dejager L, Libert C. On the trail of the glucocorticoid receptor into the nucleusand back. Traffic 2012;13:364-74.
40. McInnes IB, Schett G. Pathogenetic insights from the treatment of rheumatoid arthritis. Lancet 2017;389:2328-37.
41. Rein P, Mueller RB. Treatment with biologicals in rheumatoid arthritis: an overview. Rheumatol Ther 2017;4:247-61.
42. Badri W, Miladi K, Nazari QA, Greige Gerges H, Fessi H, Elaissari A. Encapsulation of NSAIDs for inflammation management: overview, progress, challenges and prospects. J Pharm 2016;515:757-73.
43. Siebert S, Tsoukas A, RobertsonJ, McInnes I. Cytokines as therapeutic targets in rheumatoid arthritis and other inflammatory diseases. Pharmacol Rev 2015;67:280-309.
44. Razak Abdul Salmi, Bakry Makmor Mohd, Redzuan MD-Adyani. Management of rheumatoid arthritis: special consideration for biologic disease-modifying antirheumatic drugs. Asian J Pharm Clin Res 2018;11:47-53.
45. Ogata A, Kato Y, Higa S. IL-6 inhibitor for the treatment of rheumatoid arthritis: a comprehensive review. Mod Rheumatol 2019;29:258–67.
46. Petes C, Mariani MK, Yang Y. Interleukin (IL)-6 inhibits IL-27and IL-30-mediated inflammatory responses in human monocytes. Front Immunol 2018;9:256.
47. Harirforoosh S, Asghar W, Jamali F. Adverse effects of non-steroidal anti-inflammatory drugs: an update of gastrointestinal, cardiovascular and renal complications. J Pharm Pharm Sci 2014;16:821-47.
48. Yang M, Feng X, Ding J, Chang F, Chen X. Journal of controlled release: official. J Control Release Soc 2017;252:108.
49. Liu LL, Mao YY, Gao LB. Development of rheumatoid arthritis drugs in the world. Sci Technol Rev 2016;34:44-55.
50. Liu XT, Li Q. Advances in the treatment of rheumatoid arthritis. Adv Biomed 2015;15:1171-3.
51. Smolen JS, Aletaha D, Koeller M, Weisman MH, Emery P. New therapies for the treatment of rheumatoid arthritis. Lancet 2007;370:1861-74.
52. Lu S, Wang Q, Li G, Sun S, Guo Y, Kuang H. The treatment of rheumatoid arthritis using Chinese medicinal plants: from pharmacology to potential molecular mechanisms. J Ethnopharmacol 2015;176:177-206.
53. Chandrappa M, Biswas S. Glucocorticoids in management of adult rheumatoid arthritis-current prescribing practices and perceptions of physicians in India: Glumar survey. Rheumatol Curr Res 2017;7:220.
54. Movahedi ME, Beauchamp. Risk of incident diabetes mellitus associated with the dosage and duration of oral glucocorticoid therapy in patients with rheumatoid arthritis. Arthritis Rheumatol 2016;68:1089-98.
55. Al-Rashed F, Calay D. Celecoxib exerts protective effects in the vascular endothelium via COX-2-independent activation of AMPK-CREB-Nrf2 signalling. Sci Rep 2018;8:6271.
56. Brown PM, Pratt AG, Isaacs JD. Mechanism of action of methotrexate in rheumatoid arthritis, and the search for biomarkers. Nat Rev 2016;12:731.
57. Comi G, Freedman L MS. Pooled safety and tolerability data from four placebocontrolled teriflunomide studies and extensions. Multiple Sclerosis Related Disorders 2016;5:97-104.
58. Behzadi S, Serpooshan V. Cellular uptake of nanoparticles: journey inside the cell. Chem Soc Rev 2017;46:4218-44.
59. Dolati S, Sadreddini S, Rostamzadeh D, Ahmadi M, Jadidi-Niaragh F, Yousefi M. Utilization of nanoparticle technology in rheumatoid arthritis treatment. Biomed Pharmacother 2016;80:30-41.
60. Kumar V, Leekha A, Tyagi A, Kaul A, Mishra AK, Verma AK. Preparation and evaluation of biopolymeric nanoparticles as drug delivery system in effective treatment of rheumatoid arthritis. Pharm Res 2017;34:654-67.
61. Heo R. Dextran sulfate nanoparticles as a theranostic nanomedicine for rheumatoid arthritis. Biomaterials 2017;131:15-26.
62. Aly AM, Furst DE. Update of sarilumab to treat rheumatoid arthritis based on randomized clinical trials: a systemic review. Expert Rev Clin Immunol 2017;13:741-52.
63. Fleischmann R, van Adelsberg J, Lin Y. Sarilumab and non-biologic disease modifying antirheumatic drugs in patients with active rheumatoid arthritis and inadequate response to tumor necrosis factor inhibitors and inadequate response or intolerance to tumor necrosis factor inhibitors. Arthritis Rheumatol 2017;69:277-90.
64. Verden A, Dimbil M, Kyle R, Overstreet B, Hoffman KB. Analysis of spontaneous postmarket case reports submitted to the FDA regarding thromboembolic adverse events and JAK inhibitors. Drug Saf 2018;41:357-61.
65. Abushouk AI. Safety and efficacy of ocrelizumab in rheumatoid arthritis patients with an inadequate response to methotrexate or tumor necrosis factor inhibitors: a systematic review and meta-analysis. Rheumatol Int 2017;37:1053-64.
66. Pers YM, Jorgensen C. Perspectives of atumumab as CD20 targeted therapy in rheumatoid arthritis and other autoimmune diseases. Immunotherapy 2016;8:1091-6.
67. Emery P. A phase III randomised, double-blind, parallel-group study comparing SB4 with etanercept reference product in patients with active rheumatoid arthritis despite methotrexate therapy. Ann Rheum Dis 2017;76:51-7.
68. Kay J. Consensus-based recommendations for the use of biosimilars to treat rheumatological diseases. Ann Rheum Dis 2018;77:165-74.
69. Gabay C, Riek M, Scherer A, Finckh A. Effectiveness of biologic DMARDs in monotherapy versus in combination with synthetic DMARDs in rheumatoid arthritis: data from the swiss clinical quality management registry. Rheumatology 2015;54:1664-72.
70. Teitsma XM, Marijnissen AKA. Tocilizumab as monotherapy or combination therapy for treating active rheumatoid arthritis: a meta?analysis of efficacy and safety reported in randomized controlled trials. Arthritis Res Ther 2016;18:211.
71. Fleischmann R, Schiff M. Baricitinib, methotrexate, or combination in patients with rheumatoid arthritis and no or limited prior disease?modifying antirheumatic drug treatment. Arthritis Rheumatol 2017;69:506-17.
72. Karami J, Mahmoudi M. Promoter hypermethylation of BCL11B gene correlates with downregulation of gene transcription in ankylosing spondylitis patients. Genes Immunity 2017;18:170-5.
73. Gupta V, Sengupta M, Prakash J, Tripathy BC. Pharmacogenomics and pharmacogenetics. Basic Appl Aspects Biotechnol 2017;1:151-66.
74. Tavakolpour S, Alesaeidi S, Darvishi M. A comprehensive review of rituximab therapy in rheumatoid arthritis patients. Clin Rheumatol 2019;38:2977-94.
75. Ramiro S, Sepriano A, Chatzidionysiou K. Safety of synthetic and biological DMARDs: a systematic literature review informing the 2016 update of the EULAR recommendations for management of rheumatoid arthritis. Ann Rheum Dis 2016;76:1101-36.
76. Van Vollenhoven R. Treat-to-target in rheumatoid arthritis-are we there yet? Nat Rev Rheumatol 2019;15:180-6.
77. Choudhary M, Kumar V, Malhotra H. Medicinal plants with potential anti-arthritic activity. J Intercult Ethnopharmacol 2015;4:147-53.
78. Xiao M, Fu X, Ni Y. Protective effects of Paederia scandens extract on rheumatoid arthritis mouse model by modulating gut microbiota. J Ethnopharmacol 2018;226:97-104.
79. Wang J, Chen N, Fang L. A systematic review about the efficacy and safety of tripterygium wilfordii hook. f. preparations used for the management of rheumatoid arthritis. J Evid Based Complementary Altern Med 2018;2018:1-13.
80. Aoki R, Kamikado K, Suda W. A proliferative probiotic bifidobacterium strain in the gut ameliorates progression of metabolic disorders via microbiota modulation and acetate elevation. Sci Rep 2017;7:43522.
81. Balakrishnan B, Luckey D, Marietta E. Development of a real-time PCR method for quantification of Prevotella histicola from the gut. Anaerobe 2017;48:37-41.
82. Abbasi M, Mousavi MJ, Jamalzehi S, Alimohammadi R, Bezvan MH, Mohammadi H, et al. Strategies toward rheumatoid arthritis therapy: the old and the new. J Cell Physiol 2019;234:10018-31.
83. Olsen IC, Lie E, Vasilescu R, Wallenstein G, Strengholt S, Kvien TK. Assessments of the unmet need in the management of patients with rheumatoid arthritis: analyses from the NOR-DMARD registry. Rheumatology 2019;58:481-91.
84. Xu-zhao Li, Shuai nan-Zhung. Herbal compounds for rheumatoid arthritis: Literature review and informatics prediction. Phytother Res 2019;34:1-16.
85. Kalaiselvan S, Rasool M. Triphala herbal extract suppresses inflammatory responses in LPS-stimulated RAW 264.7 macrophages and adjuvant-induced arthritic rats via inhibition of NF-kappa B pathway. J Immune Toxicol 2016;13:509-25.
86. Peterson CT, Denniston K, Chopra D. Therapeutic uses of triphala in ayurvedic medicine. J Altem Complement Med 2017;23:23:607-14.
87. Lone AH, Ahmad T, Niyar AH. Clinical evaluation of efficacy of Majoon Ushba and roghane hindi in the management of psoriasis: a randomized single-blind, placebo-controlled study. J Ayurveda Int Med 2011;2:26-31.
88. Murunikkara V, Rasool MK. Trikatu, an herbal compound mitigates the biochemical and immunological complications in adjuvant induced arthritic rats. Int J Rheum Dis 2017;20:298-308.
89. Shasmita, Rai MK, Naik SK. Exploring plant tissue culture in Withania somnifera (L.) Dunal: in vitro propagation and secondary metabolite production. Crit Rev Biotechnol 2018;38:836-50.
90. Dinesh P, Rsool M. Berberine, an isoquinolne alkalois suppresses TXNIP mediated NLRP3 inflammasome activation in MSU crystal stimulated RAW 264.7 macrophages through the upregulation of Nrf2 transcription factor and alleviates MSU crystal induced inflammation in rats. Int Immune Phamacol 2017;44:26-37.
91. Li H, Kong D, Xu Y. Tripterygium Wilfordii inhibits tonsillar IgA production by downregulating IgA class switching in IgA nephropathy. Oncotarget 2017;8:109027-42.
92. Ji P, Wei Y, Hua Y. A novel approach using metabolomics coupled with hematological and biochemical parameters to explain the enriching-blood effect and mechanism of unprocessed Angelica sinensis and its 4 kins of processed produts. J Ethnopharmacol 2018;211:101-16.
93. Nakamura N, Hirakawa H, Sato S, Otagaki S, Matsumoto S, Tabata S, et al. Genome structure of Rosa multiflora, a wild ancestor of cultivated roses. DNA Res 2018;25:113-21.
94. Palani Dinesh, Mahaboobkhan Rasool. Herbal formulations and their bioactive components as dietary supplements for treating rheumatoid arthritis. Chapter 22; 2019. p. 385-99.
95. Nimesh S. Herbal drug is better than allopathic drug in the treatment of rheumatoid arthritis. Int J Pharmacogn 2018;5:539-45.
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How to Cite
K., B., Q. Z. L., A. B., and G. S. P. “A NEVER-ENDING STORY OF RHEUMATOID ARTHRITIS”. International Journal of Pharmacy and Pharmaceutical Sciences, Vol. 12, no. 7, May 2020, pp. 10-17, doi:10.22159/ijpps.2020v12i7.37438.
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