|Pathogenetic therapy of rheumatoid arthritis (RA) is a complex task. According to modern views on the development of autoimmune inflammation in RA, cytokine disbalance plays a great part in RA pathogenesis. The role of NO in joint pathology is supported by several experimental and clinical laboratory studies; however, its exact role in RA remains obscure. The mechanisms of pharmacodynamic effects of of disease-modifying antirheumatic drugs (DMARDs) are only partly known. The problems associated with RA pharmacotherapy include primary resistance, poor effectiveness of formerly effective drugs, and side effects. In most cases, as few as one third of RA patients can receive therapy with the same DMARD longer than four years. Thus, new approaches to pharmacotherapy should be developed, the mechanisms by which known drugs act should be further studied, and reliable indicators of therapy effectiveness should be found.