What are biologics?
Biologics are drugs that are designed to reduce inflammation in rheumatoid arthritis (RA) by interfering with steps in the inflammation process. Different types of biologics for RA target different substances involved in inflammation. For example, some biologic drugs bind tumor necrosis factor (TNF)-alpha. Others inhibit interleukins (interleukin-1, interleukin-6). Still others interfere with the action of T cells or B cells. Inflammation is the primary cause of painful symptoms and joint damage in RA.
How are biologics different from other drugs used to treat RA?
Some drugs are used to relieve symptoms, like pain. Others reduce inflammation but do not slow the disease. DMARDS (disease-modifying antirheumatic drugs) slow or stop the progression of RA. Biologic DMARDs specifically target the part of the immune system that is leading to inflammation and joint damage.
How effective are biologic agents used in RA?
Biologics can be helpful when the nonbiologic DMARDs do not work or stop working. Like all RA therapies, some biologics may work well for one person but not for another. Also, a biologic may work well for a while and then lose effectiveness. However, most people can find a treatment that will work for them.
Most biologics increase the risk of serious infections, including tuberculosis and serious bacterial or fungal infection. These infections may require treatment in a hospital; in some cases, people have died from these infections. Patients should be tested for TB before starting biologics and then monitored for TB during treatment. Biologic treatment should be stopped if the patient develops a serious infection or TB.
Can biologics be taken with other drugs for RA?
Some biologics may be used alone but are often given with other nonbiologic RA drugs. Biologic drugs should not, however, be taken together. Biologics interfere with the immune system's ability to fight infection, they also increase the risk of infection. When biologics are taken together, the risk of infection is greater. Before starting a biologic drug for RA, tell your doctor about all of your medical conditions as well as all the medicines you take. Be sure to include prescription and nonprescription medicines, vitamins, and herbal supplements. You should not receive live vaccines while taking a biologic drug.
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