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Biologics for Rheumatoid Arthritis Treatment

In the last decade, there have been significant advances in treating rheumatoid arthritis, especially for patients whose arthritis does not respond to traditional disease-modifying antirheumatic drugs (DMARDs). The most important advance has been the development of a group of drugs called biologic response modifiers or biologics. 

There are a number of biologics approved to treat rheumatoid arthritis. These include:

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  • Actemra
  • Cimzia
  • Enbrel
  • Humira
  • Kineret
  • Orencia
  • Remicade
  • Rituxan
  • Simponi

Other biologics are being studied to treat rheumatoid arthritis as well as other conditions.

How Do Biologics Treat Rheumatoid Arthritis?

Biologics are genetically engineered proteins derived from human genes. They are designed to inhibit specific components of the immune system that play pivotal roles in fueling inflammation, which is a central feature of rheumatoid arthritis.

Biologics are used to treat moderate to severe rheumatoid arthritis that has not responded adequately to other treatments. They differ significantly from traditional drugs used to treat rheumatoid arthritis in that they target specific components of the immune system instead of broadly affecting many areas of the immune system. Biologics may be used alone but are commonly given along with other rheumatoid arthritis medications.

Biologics have been shown to help slow progression of rheumatoid arthritis when all other treatments have failed to do so. Aggressive rheumatoid arthritis treatment is known to help prevent long-term disability from RA.

What Are the Side Effects of Biologics?

The most common side effect seen with biologics is pain and rash at the injection site. This occurs in less than 30% of patients. Since biologics given by infusion (in the vein) have the potential to cause an allergic infusion reaction, patients are monitored during infusions. Symptoms of infusion reactions include flu-like illness, fever, chills, nausea, and headache.

As with any drugs that suppress the immune system, biologic therapy poses some increased to infections and other diseases. People taking biologics should seek immediate medical attention if they develop persistent fever or unexplained symptoms. Vaccinations that prevent infections should be considered prior to taking biologics. While taking biologic medications people should not receive live vaccines.

Biologics may also cause some chronic diseases that are dormant (such as tuberculosis) to flare, and they are not recommended for people with multiple sclerosis and other conditions such as severe congestive heart failure. All patients should be skin tested for tuberculosis prior to starting biologics, and many are also tested for chronic hepatitis.

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