Facts About Biologics for RA

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
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    Facts About Biologics for RA
    Over the last decade, significant progress in the treatment of RA has been made because of drugs known as biologics. Biologic drugs are proteins made from human genes that are mass-produced inside non-human cells. Your doctor may suggest biologics if you respond poorly to other treatments. Here's what you should know about these exciting advancements and how they may be able to improve your RA and your quality of life.
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    How Biologics Work
    RA is an autoimmune disease. This means your body mistakes some of its own tissues as foreign substances and attacks itself. In RA, when your immune system attacks your joint tissue, it causes inflammation that damages your joints and makes them painful. Biologics are designed to inhibit the cells that cause your immune system to go into this mistaken overdrive.
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    How Biologics Are Given
    Because most biologics are made of such large protein molecules, your body cannot absorb them if you swallow them in a pill or liquid form. So most biologics that the U.S. Food and Drug Administration (FDA) has approved for RA by must be injected beneath the skin or given intravenously. However, the FDA has approved one oral biologic for RA, and more are in development.
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    Who Can Benefit Most from Biologics
    Your doctor may suggest biologics if your RA is moderate to severe and has not responded to traditional treatments. You may be given biologics alone or with other medications to increase their effectiveness and decrease their side effects. Biologics have been shown to be effective in two out of three people who use them.
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    When You'll Feel the Results
    Studies show that RA patients who are given biologics generally show improvement in about 4 to 6 weeks. However, many patients report less joint swelling and discomfort soon after their first or second injection. How often your injections are scheduled depends on which biologic you're given. Some are given daily; others, every few weeks.
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    Common Side Effects
    Most biologics are well-tolerated. But the safety profile for biologic drugs varies considerably. About a third of people given biologics experience a skin reaction at the site of the injection. This could be a burning or itching sensation or a rash that will go away on its own in a week or two. Take immediate action if you develop any kind of fever. A more serious side effect is your increased risk of infection, including tuberculosis, when taking biologics. You can work with your doctor to recognize the signs and symptoms of infection.
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    The Cost of Biologics
    Biologics are expensive, between $12,000 and $30,000 a year. Because they are produced from live organisms, the materials needed to make them are expensive. The manufacturing process is more complicated than that for traditional drugs made from chemicals. Their cost also reflects the cost of research and development. Generic versions, which could cost less, are not yet available.
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    Biologics and Cancer Risk
    There is some concern about long-term, serious risks from taking biologics, including some forms of cancer, but the research is inconclusive. Because of the relative newness of biologics, any long-term risks are not yet known. It's difficult to draw hard and fast conclusions from the small amount of existing research. Always weigh the benefits and the risks of all treatment options through a careful discussion with your rheumatologist.
Facts About Biologics for RA
  1. Afraid of Drug Side Effects? Arthritis Foundation. http://www.arthritis.org/living-with-arthritis/treatments/medication/side-effects/understanding-medication-risks.php
  2. Biologics Overview. Arthritis Foundation. http://www.arthritis.org/living-with-arthritis/treatments/medication/drug-types/biologics/drug-guide-biologics.php
  3. Rheumatoid Arthritis Treatment. Johns Hopkins Arthritis Center. https://www.hopkinsarthritis.org/arthritis-info/rheumatoid-arthritis/ra-treatment/
  4. Wolfe F and Michaud K. Biologic Treatment of Rheumatoid Arthritis and the Risk of Malignancy. Arthritis Rheum. 2007 Sep;56(9):2886-95.
  5. Askling J and Bongartz T. Malignancy and Biologic Therapy in Rheumatoid Arthritis. Curr Opin Rheumatol. 2008 May;20(3):334-9.
  6. Treatments. American College of Rheumatology. https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Treatments
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Last Review Date: 2021 Jun 3
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.