Biologics

Biologic therapies are a relatively new group of drugs developed to target parts of the immune system linked to joint swelling and inflammation. Whereas older drugs targeted the immune system quite broadly, biologics are very specific and therefore can be very effective. Because these drugs affect the immune system, it is important to report any symptoms of infection to your doctor. The National Rheumatoid Arthritis Society have produced an information booklet [PDF] about biologics in the context of rheumatoid arthritis.

Adalimumab (Humira)

This targets a part of the immune system called tumour necrosis factor (TNF) which can play a role in causing pain, inflammation and joint damage in the body. Adalimumab may be prescribed for diseases like rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and juvenile idiopathic arthritis. Adalimumab may only be prescribed if you have tried other kinds of treatment first, and it cannot be used if you have a current infection. There are some health checks that need to be performed before starting it, and it will require you to have your health and any side effects regularly monitored. For more information from Arthritis Research UK, click here.

Etanercept (Enbrel)

This drug is also an anti-tumour necrosis factor treatment which works in a similar way to adalimumab (see above). A health check up is required before treatment starts, including an X-ray and blood test, and this drug requires regular monitoring for side effects. It can only be prescribed once other treatments have been tried first, and there are certain exclusion criteria, as with adalimumab. For more information from Arthritis Research UK, click here.

Golimumab (Simponi)

Golimumab is an anti-tumour necrosis factor treatment which works in a similar way to adalimumab and etanercept (see above). As with the other anti-TNFs, a health check up is required before treatment starts, and this drug requires regular monitoring for side effects. It can only be prescribed once other treatments have been tried first, and there are certain exclusion criteria, as with adalimumab and etanercept. For more information from Arthritis Research UK, click here.

Infliximab (Remicade)

Infliximab is an anti-tumour necrosis factor treatment which works in a similar way to the other anti-TNFs listed above. A health check up is required before treatment starts, and this drug requires regular monitoring for side effects. It can only be prescribed once other treatments have been tried first, and there are certain exclusion criteria. For more information from Arthritis Research UK, click here.

Rituximab (MabThera)

Rituximab works slightly differently to the anti-TNFs, instead targeting the B-cells within the immune system, which can cause inflammation and unpleasant symptoms associated with that. As such, it targets a different group of conditions, including rheumatoid arthritis, lupus, vasculitis and dermatomyositis. As with the anti-TNFs, you must have tried other treatments first, and there are exclusion criteria for this treatment. A health check will be required prior to treatment, and regular monitoring once it has started. For more information from Arthritis Research UK, click here.

Tocilizumab (RoActemra)

This drug works against a protein called IL-6, which, in excess, can cause inflammation, tissue damage, anaemia and tiredness. It is generally used for rheumatoid arthritis or juvenile idiopathic arthritis. It is usually prescribed in combination with methotrexate. As with the other biologics, you must have tried other treatments first, and a health check is required before starting this drug. On-going monitoring of health and side effects is also necessary once the drug is started. For more information from Arthritis Research UK, click here.

Last updated: October 3, 2017