Eficacia del tratamiento con biológicos antirreumáticos en el curso artritis reumatoide. Revisión Sistemática

Abstract

La Rheumatoid arthritis is a chronic systemic inflammatory disease that affects the joints, causing pain, stiffness, deformity, and decreased quality of life and functionality in patients, resulting in irreversible joint damage and progressive disability if not adequately treated. Biologic disease-modifying antirheumatic drugs (DMARDs)—certolizumab pegol, etanercept, and tocilizumab—have revolutionized clinical management by providing an effective alternative to control inflammatory activity and inducing clinical remission, thereby improving patients' quality of life. Objective: To conduct a systematic review of the literature on the efficacy of biologic disease-modifying antirheumatic drugs in patients with rheumatoid arthritis. Methodology: The study, with a retrospective descriptive qualitative approach, follows the PRISMA 2020 model for systematic review. It evaluated the efficacy of biologic disease-modifying antirheumatic drugs—certolizumab pegol, etanercept, and tocilizumab—used as monotherapy or combined with conventional DMARDs or corticosteroids. Nineteen articles were selected based on inclusion criteria. Results: Certolizumab pegol, tocilizumab, and etanercept demonstrated efficacy in achieving clinical and functional remission, with Clinical Disease Activity Index (CDAI) remission rates of 52.3%, 50%, and 43%, respectively. They significantly improved quality of life as measured by the Health Assessment Questionnaire – disability Index (HAQ-DI). Certolizumab pegol showed a lower incidence of serious infections, tocilizumab presented a higher risk of hepatic and hematological abnormalities, and etanercept a higher frequency of respiratory infections. Conclusions: Biologics are effective and safe for the management of rheumatoid arthritis, with differences in efficacy and safety profile that guide the individualized choice of treatment in combination with conventional drugs to enhance clinical and functional response. Keywords: rheumatoid arthritis, biologics, treatment, efficacy