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How Biologics Treat Rheumatoid Arthritis

Biologics are a type of drug that treats rheumatoid arthritis (RA). They work on your immune system to curb inflammation.

Biologics are often used if DMARDs (disease-modifying antirheumatic drugs) are not working well enough to control the disease. You can also take other types of RA drugs with them.

How Biologics Work for RA Treatment

Biologic drugs target immune system triggers that cause joint inflammation and damage in rheumatoid arthritis. Each works in one of these ways:

  • Curbing T cell activation. T cells are a type of white blood cell and part of the immune system. The drug Orencia (abatacept) works in this way.
  • Blocking TNF (tumor necrosis factor). TNF is an inflammatory chemical your body makes. Cimzia (certolizumab pegol), Enbrel (etanercept), Humira (adalimumab), Remicade (infliximab), and Simponi (golimumab) all work in slightly different ways to do this.
  • Blocking IL-1 or IL-6. IL-1 and IL-6 are inflammatory chemicals your body makes. Actemra (tocilizumab) blocks IL-6. Kineret (anakinra) blocks IL-1.
  • Blocking B cells. B cells are a type of white blood cell. The drug Rituxan (rituximab) works this way.

Controlling inflammation is essential to relieve joint pain and other symptoms, and to slow down or stop joint damage. Getting inflammation to the lowest level as soon as possible and keeping it low can slow down RA and reduce damage to joints.

Biologics in Treatment

Biologics may be used alone, but more often they are given with one or more DMARDs. That combination improves symptoms and disease activity and limits side effects from any one drug.

Most people who start biologic therapy begin with a TNF-blocking drug. Finding the right medication can take some time, since one person may respond better to a certain drug than another.

All biologics have been shown to slow or even stop the progression of structural damage to the joints.

People taking a biologic drug usually have quick improvement in the symptoms of RA, and studies show that these improvements usually last.

Several studies have reported that adding a biologic drug to treatment improves physical function, such as the ability to do daily activities.

Because biologic drugs suppress the immune system, you’re more likely to get an infection. Most cases are mild, such as a cold or sinus infection. But some have been life-threatening and even fatal, including infections such as tuberculosis. That’s why doctors monitor patients taking biologics carefully for serious infections.

Each drug has its own set of side effects that you should discuss with your doctor.

WebMD Medical Reference

Reviewed by David Zelman, MD on June 25, 2013
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