Video Q & A:

Biologics

Question:

Are biologics right for everyone?

Expert:   Linda Russell, MD, Hospital for Special Surgery »

Biologics aren't appropriate for certain people with rheumatoid arthritis. Check out this video to learn if you're a candidate for biologic therapy.

Transcript: Biologics are powerful drugs—SO powerful that they have the potential to send rheumatoid arthritis into remission and prevent joint damage. But biologics suppress the immune system and that increases the risk for infection and may trigger allergic reactions, so you must be carefully monitored while taking them. Biologics are created from human proteins. They’re engineered to target different components of your immune system on a MOLECULAR level. When used to treat rheumatoid arthritis, they prevent your white blood cells and other inflammatory substances from mistakenly attacking your healthy joint lining. The most popular biologics are called TNF inhibitors. There are five—etanercept, adalimumab, infliximab, certolizumab pegol and golimumab. If a patient has: multiple sclerosis, vasculitis, certain blood diseases, chronic obstructive pulmonary disease, [or COPS], a history of severe HEART disease and failure, or a history of cancer, he or she should AVOID TNF inhibitors. Also, active tuberculosis, SEPSIS, alcoholic hepatitis, VIRAL hepatitis and other serious active infections must be treated BEFORE a doctor can consider prescribing TNF inhibitors. Even after treatment, there’s a risk that TNF inhibitors can reactivate the disease. Traditional DMARDs such as methotrexate and corticosteroid medications may help people who CAN’T take biologics. In addition to those with specific health problems, certain GROUPS of people should avoid biologics. Only adalimumab and etanercept have been FDA-approved for use in children with juvenile idiopathic arthritis. More research needs to be done to see if the other biologics have adverse effects in kids. Also, pregnant WOMEN should stop biologic treatment. Studies are still ongoing, but since safety has not been proven, it’s better to avoid the risk completely. As always, you need to discuss the risks and benefits with your doctor BEFORE undergoing any treatments! Learn more about biologics by checking out other videos in this series. More »

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