Rheumatoid Arthritis: Biologic Drugs at a Glance

Medically Reviewed by David Zelman, MD on February 12, 2024
4 min read

Biologic drugs are one type of medicine doctors use to treat moderate to severe rheumatoid arthritis (RA). They work on your immune system to ease inflammation and damage in your joints.

Use this list to get to know the different types.

How you take it: By injection or IV

How often you take it: Depends on how you take it. You can get it by injection every week or by IV once a month.

Most common side effects: Headache, cold, sore throat, and nausea

Your doctor should:

  • Test you for tuberculosis and hepatitis before you take it
  • Check you for infections, including tuberculosis, while you take it

How it works: It blocks the immune system's T cells to lower inflammation.

How you take them: By injection

How often you take them: Once every 2 weeks

Most common side effects: Colds, sinus infection, headache, and rash

Your doctor should:

  • Test you for tuberculosis and hepatitis before you take them
  • Check you for infections, including tuberculosis, while you take them

How it works: It targets tumor necrosis factor (TNF), a chemical your body makes that causes inflammation. Your doctor will call this type of drug a “TNF blocker.”

How you take them: By mouth

How often you take them: You can take once or twice a day with or without food

Most common sides effects: cold, sinus infection, fever, nausea

Your doctor should:

  • Test you for tuberculosis or hepatitis before you take them
  • Check you for infections, including tuberculosis, while you take them
  • Monitor you for blood clots

How they work: They are considered oral Janus kinase (JAK) inhibitors. They inhibit activity of one or more of the JAK enzymes (JAK1, JAK2, JAK3, TYK2) and help reduce inflammation.

These drugs come with serious health risks. In 2021, the FDA issued a warning about an increased risk of heart attack or stroke, cancer, blood clots, and death with these medicines.

How you take it: By injection

How often you take it: Usually every 2-4 weeks (your doctor will decide)

Most common side effects: Flu or cold, rash, urinary tract infections      

Your doctor should:

  • Test you for tuberculosis and hepatitis before you take it
  • Check you for infections, including tuberculosis, while you take it

How it works: It targets tumor necrosis factor (TNF), a chemical your body makes that causes inflammation. Your doctor will call this type of drug a “TNF blocker.”

How you take it: By injection

How often you take it: 1-2 times each week

Most common side effects: Skin reactions or pain where you get the shot, sinus infections, headache.

Your doctor should:

  • Test you for tuberculosis and hepatitis before you take it
  • Check you for infections, including tuberculosis, while you take it

How it works: It targets tumor necrosis factor (TNF), a chemical your body makes that causes inflammation. Your doctor will call this type of drug a “TNF blocker.”

How you take it: By shot or IV

How often you take it: Monthly if by injection (Simponi), every 8 weeks by IV (Simponi Aria) (Simponi Aria)

Most common side effects: Runny nose; sore throat; hoarseness or laryngitis; pain, skin reactions, or tingling where you got the shot; and viral infections like flu and cold sores.

Your doctor should:

  • Test you for tuberculosis and hepatitis before you take it
  • Check you for infections, including tuberculosis, while you take it

How it works: It targets tumor necrosis factor (TNF), a chemical your body makes that causes inflammation. Your doctor will call this type of drug a “TNF blocker.”

How you take them: By IV

How often you take them: Your doctor will decide on the dose and how often you should take them.

Most common side effects: Respiratory infections (like sinus infections and sore throat), headache, coughing, stomach pain

Your doctor should:

  • Test you for tuberculosis and hepatitis before you take them
  • Check you for infections, including tuberculosis, while you take them

How they work: They target tumor necrosis factor (TNF), a chemical your body makes that causes inflammation. Your doctor will call this type of drug a “TNF blocker.”

How you take it: By IV

How often you take it: Your first two infusions with an IV are 2 weeks apart. You can repeat the infusions every 6 months.

Common side effects: Reactions to the infusion, chills, infections, body aches, tiredness, low white blood cell count

Your doctor should:

  • Test you for tuberculosis and hepatitis B before you take it
  • Check you for infections, including tuberculosis, while you take it

How it works: It targets certain B cells, which are part of your immune system.

How you take it: By injection or IV

How often you take it: You can take it by IV once a month. Or you can get injections every week or every other week.

Most common side effects: cold, sinus infection, headache, high blood pressure, liver problems

Your doctor should:

  • Test you for tuberculosis and hepatitis before you take it
  • Check you for infections, including tuberculosis, while you take it

How it works: It targets IL-6, a chemical your body makes that causes inflammation. Your doctor will call this type of drug an “IL-6 blocker.”