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Biologics for Rheumatoid Arthritis Treatment

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What Are the Side Effects of Biologics? continued...

Biologics are also more expensive than traditional treatments. However, the evidence so far suggests that they are more effective and may pose fewer risks than other systemic therapies.

One disadvantage to biologic medications is that they must be given either by injection or by intravenous infusion, with the exception of Xeljanz. It is taken by mouth.

Although animal studies of biologics have shown no effect on fertility or impairment of the fetus, these studies cannot always predict the effects in humans. Pregnant women should receive these drugs only if clearly needed, because the effects on a developing child are unknown.

Biologics are commonly discontinued prior to surgery until wounds have healed and infection risk has passed.

As a general rule, different biologic therapies should not be taken at the same time.

Here are some details on available biologic drugs:


Actemra, given by monthly hour-long infusions or weekly (or every other week) injections, is the first IL-6 inhibitor for rheumatoid arthritis. IL-6, or interleukin-6, is a chemical messenger of the immune system.

Actemra is used to treat moderate to severe rheumatoid arthritis in patients who have not responded to one or more TNF inhibitors. TNF inhibitors include Cimzia, Enbrel, Humira, Remicade, and Simponi.

The most common side effects include upper respiratory tract infection, inflammation of the nose or throat, headache, high blood pressure, and elevated liver enzyme level.


Cimzia works by blocking the action of a substance in your body called tumor necrosis factor (TNF). Cimzia is an injection. Through the use of prefilled syringes, you can give it to yourself once you are taught to do so by a doctor or nurse. After the initial doses, Cimzia can be taken every 2 to 4 weeks, depending on the dose your doctor feels is right for you.

In addition to pain at the injection site, the most common side effects seen with Cimzia are upper respiratory infections -- such as a cold -- headache, high blood pressure, inflammation of the nose and throat, and back pain.

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