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Treating RA: Is It Time for a Biologic?

Using Biologics for Rheumatoid Arthritis

There are a number of biologics to choose from. They work in different ways. TNF-blockers target a chemical messenger that triggers swelling. Other biologics affect different molecules involved in the immune response.

It can take a few tries before finding the biologic that works best for you. Sometimes, a drug that used to work stops helping and a new one needs to be substituted.

While it can be disappointing when a drug doesn't work, take heart.

"Switching biologics is common," says Matteson. "In the vast majority of patients, we can find a medication strategy that gets the disease under control and keeps it that way."

Biologics for Rheumatoid Arthritis: Side Effects

Biologics and other DMARDs work by blocking attacks from the immune system. That's their drawback, too. By suppressing the immune system, you become more vulnerable to infection and other problems.

The exact side effects depend on the specific drug. Some biologics can cause:

  • Skin irritation at the injection site
  • An increased risk of infections, including tuberculosis
  • An increased risk of some cancers
  • An increased risk of neurologic and heart problems

Biologics are not safe for everyone. If you have a condition like multiple sclerosis, hepatitis, or heart failure, your doctor might not recommend biologics.

Whatever you do, don't manage side effects on your own without your doctor's help by skipping doses or cutting down the amount of medicine you get. That's a bad idea, Bingham says. It could allow your RA to worsen. It could also mislead your doctor into thinking your medicine isn't working.

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