As our understanding of the pathogenesis of autoimmune diseases is growing, new 
therapies are being developed to target disease-specific pathways. Since the 
introduction of etanercept in 1998, several biotechnological agents have been 
developed, most of them indicated in the treatment of rheumatoid arthritis, but 
also psoriatic arthritis. Most currently available molecules target TNF-alfa 
with different strategies (i.e., etanercept, infliximab, adalimumab, golimumab, 
and certolizumab pegol), IL-6 (tocilizumab), CTLA-4 (abatacept), and B cells 
(rituximab, belimumab) as they are key mediators in the cascade of inflammation. 
Further, small molecules have been recently developed to target intracellular 
signaling, such as Janus Kinases for tofacitinib, the first FDA-approved small 
molecule for rheumatoid arthritis. Most novel treatments are being developed for 
arthritis with specific differences between rheumatoid and psoriatic arthritis, 
as well as for systemic lupus erythematosus, following the approval of 
belimumab. Finally, biologic therapies are effective also in gout, mainly 
targeting interleukin-1 to block the inflammasome. This review article describes 
the new and upcoming treatment options for rheumatoid arthritis, psoriatic 
arthritis, systemic lupus erythematosus, and gout to dissect what we should be 
aware of when discussing these new and promising molecules.