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Heard that same song all my life and I am 70 now.

The difference is that these actually exist now, and must make their way through clinical trials, which takes years.

So instead of academics saying "in 5 - 10 years we should have something", it's biotechs saying "we have something *now*, and we should be done with trials and development in 5 years."

You have to be exquisitely careful with this stuff - it has effects all over the immune system. We found that tuberculosis patients with that disease under control had flareups when we were tweaking the immune system to prevent it from attacking the joint tissue. It's actually a sort of throttle, a TNF antagonist that sponges up that cytokine, that control chemical. Too little and you hurt yourself, too much and you hurt yourself elsewhere.

The good news is that it can be prescribed "off-label" as long as the patient and doctor realize they're playing games with the patient's life. The downside is that you can die if you don't get it right. And animal models are only partly accurate in adjusting dosage. You want to get every possible avenue as close as possible before you start - there's no other phrase for it - experimenting on patients. You can imagine the immense medical ethics issues involved here.