The analysis of cytokines involved in pathogenesis of rheumatic diseases subsequently revolutionised the management of patients with chronic rheumatic disorders. Tumour necrosis factor-alpha (TNF-alpha) have been found to play a pivotal role in rheumatic inflammation. Since 1999 monoclonal antibodies against TNF were able to demonstrate positive effects in rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and juvenile idiopatic arthritis. After the approval of the anti-TNF-alpha inhibitors, further agents against other proinflammatory cytokines were approved (rituxumab and abatacept) and under development are many other which will be modulate the disorders of immune system in patients with infôammatory rheumatic diseases. The present article reports on efficacy and safety of biological therapy in patients with rheumatic diseases.