Reviewed by Brunilda Nazario on April 11, 2013


Dimitrios Pappas, MD, Johns Hopkins Hospital, Arthritis Center. Arthritis Foundation.

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Video Transcript

Mary Paulla Sanders: It was difficult for me to walk. Now I can actually roll out of bed and walk normal.

Narrator: Mary Sanders has rheumatoid arthritis—a chronic disease where, for reasons that are unclear, the body's immune system attacks the lining of the joints. She started treatment with an oral prescription, but…

Mary Paulla Sanders: It was not taking the swelling out of my hands…my hands were not…getting up in the morning I was stiffer…my joints were stiffer…I wasn't able to walk as well.

Dimitrios Pappas, MD: That's why recently we made the decision to advance her treatment involving a biologic agent…and we are in the beginning of evaluating the response now.

Narrator: Biologics are powerful agents that work by suppressing the immune system. Careful monitoring is necessary since biologics tend to weaken the body's ability to defend itself against viruses and bacteria.

Dimitrios Pappas, MD: Patients may be more prone to infections maybe more susceptible to infections and we try to education them about that, and if there is an infection to treat it promptly with antibiotics.

Narrator: A tradeoff many facing the prospect of permanent joint malformation and eventual bone erosion readily accept… and one that previous generations didn't have. However, biologics cannot reverse damage that has already occurred.

Mary Paulla Sanders: My mom's had it probably 30...30 years easy. 30...40 years, and there wasn't much treatment for her.

Dimitrios Pappas, MD: Okay…How 'bout joint pain?

Mary Paulla Sanders : There's still some pain on certain days but most of the time now there's very little pain.

Narrator: Depending on the particular type, treatments are either administered by infusion in a clinical setting, or by self-injection. They cost more than traditional treatment and are NOT appropriate for all patients, like those at higher risk for certain types of cancers. Plus… they're normally only prescribed after oral disease-modifying drugs fall short of the mark.

Dimitrios Pappas, MD: There is a percentage of patients who continue to do well on traditional medications and they never need a biologic.

Narrator: But for those patients who are appropriate candidates, biologics can offer the prospect of a life with far less joint pain and far greater mobility…

Mary Paulla Sanders: I'm able to make a fist now where in the beginning I was not able to make a fist.

Dimitrios Pappas, MD: So would you say that your improvement is more than 50 percent?

Mary Paulla Sanders: I would say it's more like 80 percent.

Dimitrios Pappas, MD: Oh, that's great news!

Narrator: Mary's showing noticeable progress and has already begun to enjoy an enhanced lifestyle…

Mary Paulla Sanders: I've actually decided to take up the manager role—I'm actually the manager of my department now where before I wouldn't have done it because of the pain and just feeling too tired.

Dimitrios Pappas, MD: This looks better.

Narrator: For WebMD, I'm Damon Meharg.