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What are biologic DMARDs?

Biologic disease-modifying antirheumatic drugs (DMARDs), also known as biologic agents, biologic response modifiers, or biologics, work by targeting a particular protein that contributes to rheumatoid arthritis (RA). Currently,   four types of biologics are approved to treat RA and are named for the inflammatory proteins they target:
  • TNF-blockers (also called inhibitors) -- adalimumab (Humira),   certolizumab pegol (Cimzia), etanercept (Enbrel), and infliximab   (Remicade)
  • T-cell costimulator -- abatacept (Orencia)
  • B-cell inhibitor -- rituximab (Rituxan)
  • Interleukin-1 inhibitor -- anakinra (Kineret)
Biologic DMARDs may be used on their own or in combination with other treatments, including chemical DMARDs. The most common second step in rheumatoid arthritis therapy -- after methotrexate alone -- is combination therapy with   methotrexate and a TNF-blocker. Other biologics may be used if TNF-blockers have not been effective, are not well tolerated, or are contraindicated.
A common but short-term side effect of all biologics is a skin reaction at   the injection site. And all biologics increase the risk of infection, although to different degrees. TNF-blockers have been linked to serious fungal infections, tuberculosis (TB), and some cases of nerve damage; infliximab may cause severe allergic reactions; and rituximab has been linked to a rare but life-threatening brain infection. 

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.