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Nine biologics are approved to treat rheumatoid arthritis (RA), along with an oral Jak inhibitor Xeljanz (Pfizer). Given rheumatologists’ long-standing familiarity with the safety and efficacy profiles of the TNF-alpha inhibitors and non-TNF-alpha biologics Orencia (Bristol-Myers Squibb), Rituxan/MabThera (Biogen/Roche), and RoActemra/Actemra (Roche), new agents face formidable challenges in gaining uptake in this crowded market. Nonetheless, all marketed RA drugs are associated with substantial nonresponder rates, highlighting a significant unmet need and commercial opportunity for novel therapies that can offer improved efficacy and safety.

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