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When is the right time to start biologic therapy?

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

Biologics work well, but they're not the first RA medication you'll take. Find out when it's time to consider starting them.

Transcript: Biologic response modifiers have REVOLUTIONIZED the treatment of rheumatoid arthritis, so you’d think they’d be the FIRST drug a doctor turns to treating a newly diagnosed patient. But that’s not the case. Biologics are prescribed after TRADITIONAL DMARDs—or disease-modifying anti-rheumatic drugs--are no longer an option. That’s because BIOLOGICS have more potential side effects AND cost more than traditional DMARDs. Methotrexate is usually the first DMARD an RA patient will take. It’s often augmented by another traditional DMARD. But if RA is particularly severe, traditional DMARDs may not be able to stop progression of the disease or relieve chronic pain. After 3 months or more on the medication, if there’s not enough improvement it’s time to start tumor necrosis factor-, or TNF-, inhibitors—the most popular biologics . Sometimes you may be on a DMARD for longer periods, and they SEEM to be making you feel better and better. But eventually you hit a PLATEAU and you don’t continue to see improvements. That also signals that it’s time to add a biologic to your treatment plan. You may not STOP taking the original DMARD though—you may take it ALONG with the biologic, depending on the doctor’s instructions. People who have certain HEALTH conditions or who have had an allergic or severe reaction to traditional DMARDS may also be candidates for BIOLOGICS. If you think it’s time to consider biologics, ask your doctor about them. Take a look at our other RA videos to learn more about treatment options. More »

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