The past decade has seen remarkable advances in the treatment of rheumatoid arthritis. Although this is good news for the majority of patients, one consequence is that the environment for the development of new drugs has become difficult as a result of high expectations for efficacy. Nevertheless, there remains a subgroup of patients with rheumatoid arthritis who are not candidates for treatment with the newer biologic agents and in whom oral DMARDs have certain advantages. A recent report by Bruyn et al. suggests that the proliferation-signal inhibitor everolimus could have unique properties, in addition to a convenient once-daily oral dosing schedule, that might fit this niche in the therapeutic armamentarium. Further studies are required, however, to confirm the disease-modifying effects and adverse event profile of this drug.
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