I’ll be honest…it has been 35+ years since I started Medical School MBBS. And in the realm of Medicine at large, and Immunology/Rheumatology in specific, we are still struggling to find a ‘cure’ for chronic systemic inflammatory immune-mediated diseases also known as ‘autoimmune rheumatic diseases (ARD)’. Rheumatology is still in its cradle having gotten the recognition as a subspecialty of Medicine only in 1972. I have seen the field evolve in terms of understanding the orchestrated ‘play’ of the immune cells along with cytokines etc. over the past 3 decades, all of which has led to the concept and birth of ‘biologic’ disease modifying anti-rheumatic drugs b-DMARDs. The first b-DMARD to get approved by the Food and Drugs Administration FDA was etanercept, a TNF-alpha receptor fusion protein in 1998. Infliximab, a chimeric monoclonal antibody against TNF soon followed in 1999. Ever since then, there has been a flurry of b-DMARDs including 3 more in the same family of TNF-antagonists, 2 in the Interleukin IL-6 antagonist class, 1 blocker of the second co-stimulatory T-cell signaling: CTLA-4Ig, 3 IL-1 antagonists, B-cell depleting chimeric monoclonal antibody directed against CD-20 etc. Also, 3 oral Janus-kinase inhibitors have joined the ‘gang’ and are called targeted synthetic DMARDs. I still remember the pre-b-DMARD era when rip roaring rheumatoid arthritis was still around, and with my Ustaad Saheb (Mentor), all what we had to offer pharmaceutically were the conventional synthetic cs DMARDs including methotrexate, hydroxychloroquine, sulfasalazine, leflunomide and the younger generation can hold their breath cyclosporine, d-penicillamine, chlorambucil…GOLD injections and even cyclophosphamide! Corticosteroids have been around since 1950! The 1st and “so far” …well, I/You might be next one! the only Nobel Prize winning revelation in the realm of Rheumatology...