Biologic Basics: What to Know for Your Rheumatoid Arthritis

What if your RA medications are not enough? Learn more on how you can manage the pain from your RA.

Cropped shot of an unrecognizable woman sitting alone at home and suffering from arthritis in her hands

If you’re living with rheumatoid arthritis (RA), you know that it’s essential to get treatment that not only helps you manage pain, but also halts future joint damage. Sometimes, however, traditional RA medications aren’t enough.

Enter biologics – a relatively new class of drug that’s only been in use as a treatment for RA symptoms since 1998  And while they do offer some big benefits for people who suffer from more severe joint pain and inflammation, they don’t come without risks.

Get the facts on biologic drugs and discover if they could be an effective part of your RA treatment plan with this quick cheat sheet.

What is a biologic?

Broadly speaking, the drugs used to halt the progress of RA fall into two categories: traditional DMARDs (disease-modifying antirheumatic drugs) and newer biologics, or biologic DMARDs.

Unlike traditional DMARDs, such as methotrexate, that are made with chemical ingredients, biologics are genetically engineered inside living cells and made to mimic the role of certain proteins in the body.

Traditional DMARDs are usually the first choice for treating RA. Biologic medications are usually prescribed for people with more moderate or severe RA and whose regular treatments and medication aren’t giving them relief from their symptoms.

The most commonly prescribed and approved biologic treatments for RA are:

  • adalimumab or Humira
  • certolizumab or Cimzia
  • etanercept or Enbrel
  • infliximab or Remicade
  • abatacept or Orencia
  • rituximab or Rituxan          
  • anakinra or Kineret

How do they treat rheumatoid arthritis symptoms?

Rheumatoid arthritis happens when your body’s immune cells mistakenly attack joint tissue, triggering inflammation and causing joint damage and pain.

Unlike traditional DMARDs, which affect the immune system as a whole, biologic drugs specifically target, or pinpoint, the cells responsible for this inflammation in the joints. They essentially “calm them down,” reducing inflammation and pain, and potentially protecting those joints from further damage.

In most cases, biologics are used with other RA medications – traditional DMARDs and NSAID pain relievers like ibuprofen or naproxen – to help treat and manage symptoms. 

They are most often taken via injection or intravenous (IV) infusion.

Are biologics safe?

While most patients report no severe or life-threatening side effects, this type of treatment does come with some risks.

Biologic medications are typically taken through an injection, so there’s an increased risk of infection at the injection site, along with a risk of swelling, pain or rash. IV biologics can also potentially cause symptoms such as fever, chills and head and body aches.

Because biologics work by suppressing part of the body’s immune system, they can increase your risk for various types of infection, such as respiratory or urinary tract infections, too. Biologics can also cause certain conditions (such as tuberculosis and hepatitis B) to worsen or reactivate, so you may be tested for them before starting treatment.

Will they help me manage my RA pain effectively? 

Biologics are most effective in people suffering from severe inflammation who haven’t seen relief from traditional options. They also tend to work faster and have fewer side effects. However, biologic medications affect each person differently, and it’s not possible to tell how effective the treatment is until after you’ve been taking them for around 4-6 weeks.

Biologics have been shown, however, to work better than traditional DMARDs at protecting the joints from damage caused by RA, and research has also suggested that biologic treatments can help reduce fatigue in RA sufferers.

Are biologic drugs right for me?

In addition to some unpleasant side effects, biologic treatments also come with a much higher price tag than traditional RA medication – they can cost up to $5000 per week.

That being said, many patients who have tried other conventional medications with no result have seen big improvements in their symptoms when they added biologics to their treatment plan.

The important thing is to talk with your doctor. Discuss your concerns and symptoms openly so that the two of you can decide on the most effective treatment plan for your RA pain. 

Medically reviewed in June 2019.

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