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What Are Biologic Treatments for RA? 

 June 29, 2022

By  Linda Rook

Microscope of a infection or germ.

Introduction.

Biologic reaction modifiers are a brand new drug that treats rheumatoid arthritis (RA). They have seen to have a significantly better treatment for a lot of people with RA.

Biologics are a type of DMARDs or (disease-modifying antirheumatic drugs.) Biologic comes in either injection or infusion. They are prescribed mainly when conventional DMARDs are not working; they are compelling and work with people with RA, PsA and other forms of inflammation diseases.

They are costly, though, as they are more difficult to make; they are mostly given to you by the doctor through an (IV) (intravenous infusion).

But biologics can cause problems as they can weaken your fight against infections. Also, it can work at first but stops after a while; if this happens, your doctor will try you on a different biologics or other options.

Fighting Infections

How do Biologics work?

Biologics targets parts of your immune system, which helps the inflammation, and is a genetically engineered protein. Were as non-biologic drugs having a random approach, for example, methotrexate.

Biologics are for single or a combination of biologic and non-biologics, like methotrexate. Therefore, selecting a drug for inflammatory diseases is difficult as several factors drive it.

With everything, when there is a benefit, there is a downside. The downside to biologics is that it suppresses the immune system, and there is a risk of infection. Also, there is a risk of disease or reaction around the injection or infusion site.

The benefits are that it can be life-changing for people with inflammatory arthritis.

The following are four types of biologics that can be a risk factor or a benefit.

Tumour Necrosis factor or TNF inhibitors.

Benefits – the drug can decrease the disease’s progression and reduce inflammation. TNF is often used with other medicines. You could notice your symptoms improve within two to three doses of starting the medication.

Three types are approved for children they are etanercept, adalimumab and infliximab. Also, if you are pregnant, there is a safe one called certolizumab.

Medicines Tablet form

Risk – but there is an increased risk of infection, especially tuberculosis and fungal infection. You are at low risk of tuberculosis if you have etanercept than if you have any other TNF inhibitors. When you take etanercept, you are at risk of certain types of cancer and may develop multiple sclerosis. The anti-inflammatory result of the TNF drug could reduce over time; this is because some people can form antibodies in contrast with the drug, whereas using methotrexate with biologic could reduce this.

x-ray foot

B-Cell Inhibitors

These could be belimumab and Rituxan.

Benefits - The inhibitors B-cell is usually used for treating rheumatoid arthritis when you have tried others, where they have no effect. Taking one treatment of rituximab, or two maybe fortnight apart- could last approximately a year.

Risk – the risk factor of having B-cell inhibitors can course a change in your blood pressure. You could also have chest pain, difficulty breathing, and rash. Another side effect is that you could feel dizzy and have signs of flu-like. Finally, you could be more susceptible to colds or sinus problems after the treatment.

Interleukin Inhibitors.

There are a few of these kinds of inhibitors; they are anakinra, canakinumab, and sarilumab are, just a few.

Benefits – Interleukin inhibitors are used when people have no effect from the TNF and are tolerated by most people.

Risk – In rare cases, there may be a small hole in the gastrointestinal tract called bowel perforation. Also you should look out for changes in your body temperature and abdominal discomfort, if your bowel movement is unusual, symptoms of infection or headaches.

A weekly box of medication.

Selective Co-stimulation Modulators.

There is one of this called abatacept.

Benefits – this is to be a first-line treatment for those with moderate to severe RA. But it is usually used after using any other DMARDs, particularly methotrexate that doesn’t work sufficiently. In addition, this biologic can be used for children with juvenile idiopathic arthritis. After four or six weeks of having abatacept, you will find relief from your inflammation, pain, stiffness and swelling of the joints.

It would be more effective to combine this with methotrexate as it has fewer interactions with other drugs.

Risk – with abatacept, you should be conscious of pneumonia, tuberculosis and influenza.  Other side effects could be cough, sore throat, nausea and headache.

Biologics and how are they given.

Most of them are by injection; some are placed beneath the skin and pores. Others are into a vein.

Injection Site Reaction.

Some reactions around the injection area are common, particularly at the beginning of the treatment. The reactions around the injection site could be:

  • Itching.
  • Swelling.
  • Redness.
  • And Pain.

If you get any of these reactions, you could treat it with a cold compress, oral antihistamine or acetaminophen. However, you must call the doctor when the response gets worse or is still there after five days. It will help if you change the injection site each time.

At the start of your first infusion.

Before you are booked in for your biologic infusion, you could obtain ‘pre-meds’; for example, antihistamine and antiemetic or an NSAID; they will help if you have any reactions such as:

inflammation of the knee
  • Pain and Swelling.
  • At the infusion site you may have redness.
  • You may feel nausea or get a headache.
  • You could have a rash around the site.

When the biologic is by infusion, the nurse or doctor will take your temperature with your blood pressure and pulse; then, a nurse will monitor you throughout and after to ensure you are OK to go home.

There may be a severe reaction that may stop the infusion so that they can treat any of the following:

  • You may encounter difficulty in breathing.
  • Your chest may become tight and painful.
  • Your blood pressure may become high or low.
  • You may develop swelling in the face and hands.
  • You may become feverish or chills.
Chest pain and feeling tight

The Infection site.

When you have biologic therapy, it suppresses the immune system. Because of this, the treatment could leave you open to infections.

The common infections could be:

  • Colds or you could get a sore throat.
  • Upper respiratory infection or sinus problems.
  • Bronchitis or urinary tract infection.

The list below will show you how to avoid these infections:

  • You must frequently wash your hands.
  • If you can avoid crowded and enclosed places.
  • Try and avoid public transport like buses etc…
  • Childcare places.
  • If any family or friends are sick, they should not visit you.
  • You should speak to your doctor if you have a prior appointment for dental treatment, manicures or vaccinations.
  • You must not share utensils, cups or personal items with anyone.
  • Avoid swimming in lakes, ponds, pools, and using a hot tub.
  • You should consult with your doctor if you have a pet. For example, it’s best if you don’t change the cat litter, clear up after your dog, and avoid farm animals, birds, fish and rodents.
  • Ask your doctor if it’s safe to work with soil in the garden.
  • And avoid unpasteurized food such as raw eggs or fish, soft cheese and shellfish.

Sorry it's such a long list, but this is to avoid you having any infection.

Safety notes on self-injection.

1. Keep your medicine in the fridge. Most of the biologics should come to room temperature before using.

2. Do not at any time freeze or shake the drug.

3. Make sure it is all sterile – clean the area with alcohol, wear gloves, and ensure the table is clear of contamination.

4. Always discard the syringe and needles safely (in your approved ‘sharps’ box. That your pharmacist provides and disposes of on request.

Conclusion.

ALWAYS consult your doctor if you have an unusual symptom, such as a fever or signs you cannot explain. For example, the biologic can cause an inactive infection to become active; because of this, you should have tuberculosis and hepatitis MRI at the early stages. Unfortunately, if you have a liver problem, you won’t be able to have the biologic drug.

Some biologics can take effect quickly, but others could take effect over a couple of weeks or months; this is because everyone can respond to medication differently, and not everyone can respond the same.

Biologics are better for managing the symptoms of the old type of medication for RA. Most are given by injection and have fewer side effects.

I hope this article has helped you. Please subscribe to my website, and I will keep you updated on new blogs. Also, if you need to know anything about arthritis, please go to my contact page and leave a message, and I will get back to you.

In the meantime, if this post is informative, I’d be very grateful if you’d help your friends or family if they have a similar condition to tell them. So please share it on Twitter or Facebook or send them an email.

I am not a medical professional, and this blog is for information only. If you have any worries, you should consult your doctor.

I hope this blog has helped.

https://foodwitharthitis.com

More Information.

https://www.arthritis.org/drug-guide/biologics/biologics

Linda Rook

Linda is now retired and has suffered from Osteoarthritis for about 40+ years.  She struggled with her weight until she found the correct one that also helped with her arthritic pain.  Linda was in terrible pain until the physician thought her right hip needed replacement. 


Now Linda has an artificial right hip, which has left her with the left leg shorter than the right.  Therefore, her spine is now wonky, and has arthritis of the lower back, also it seems to be going all over the body, her pain is now in the knees, elbow, wrist, fingers and both hips.


Linda now spends her days writing information to help others with the same conditions, so they do not suffer like Linda.


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