Biologics
BIOLOGIC RESPONSE MODIFIERS

The “biologics” (or biologic response modifiers) technically are a subset of DMARDs. Like DMARDs, the biologics stop disease progression; sometimes they initiate a long-lasting remission. Moreover, these drugs often work for people in whom other therapies have failed. In fact, studies show that two-thirds of people with RA respond favorably to a biologic, with most of them achieving remission. In many cases, biologics are used together with standard DMARDs, such as methotrexate.

Unlike DMARDs, which may be used in combination with one another, two biologics are not used together. For instance, abatacept (Orencia), anakinra (Kineret) and rituximab (Rituxan) should not be used with TNF-a inhibitors, and TNF-a inhibitors should not be combined.

Although the biologics work in different ways, all block specific steps in the inflammation process. Adalimumab (Humira), etanercept (Enbrel) and infliximab (Remicade) block a cytokine called tumor necrosis factor-alpha (TNF-a). Kineret blocks a cytokine called interleukin-1 (IL-1). Abatacept (Orencia) blocks the activation of T cells. Rituximab (Rituxan) blocks B cells.

Like many drugs, biologics have a downside, most often, expense. Also, the drugs must be infused intravenously or injected. Researchers say that future agents may be less expensive and taken orally.

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