Monoclonal antibodies have undergone a radical evolutionary journey over the last 25 years, with advances in molecular biology, process development and drug formulation underpinning their rise to becoming one of the most efficacious and economically important class of drug today. The success of antibodies for the treatment of rheumatological conditions, such as rheumatoid arthritis in particular, has driven the biopharmaceutical industry to optimize all aspects of therapeutic antibody discovery and development, in order to provide further benefits for patients over and above marketed treatments, via increased clinical efficacy and patient convenience. Recent advances in many of the key aspects of antibody design that are driving this evolution, such as affinity optimization, effector function modulation, pharmacokinetic engineering, as well as developments in subcutaneous drug delivery, are reviewed here.