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Biologic Agents and the Treatment of Autoimmune Disorders

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The immune system plays a vital role in keeping the body healthy. The system includes blood cells and organs that work to fight and remove germs. Sometimes the immune system misfires. It begins to attack healthy tissue in the body. This is called an autoimmune disorder. Over time this kind of disorder can cause severe damage to tissue such as joints or organs. Treatment may help to slow or stop this process.

Biologic medicine is one part of treatment. This medicine is made with proteins from living cells. It allows the medicine to:

  • Target parts of the system that control inflammation
  • Create very specific effects

Biologic Agents and the Treatment of Autoimmune Disorders

The biologic agent can limit part of the immune system. This can slow or stop damage to healthy tissue.

Autoimmune disorders that have been treated with biologic agents include:

Side Effects of Biologic Agents

Side effects will depend on:

  • Type of biologic agent
  • Dose—how much of medication you take and how often
  • How it is delivered—injection or through IV

The body’s reaction can also vary. Some possible side effects of biologic therapies include:

  • Infection
  • High blood pressure
  • Lightheadedness
  • Flu-like symptoms, such as fever, chills, muscle and joint aches
  • Nausea and/or vomiting
  • Redness, rash, and/or pain at injection site
  • Headache
  • Allergic reaction
  • Increased risk of Hodgkin and non-Hodgkin lymphoma and other types of cancer in children and teens taking TNF inhibitors
  • Possible reactivation of latent tuberculosis infections with TNF inhibitors

If your doctor recommends biologic therapy:

  • Ask about which side effects and complications you may have.
  • Ask if you should be tested for tuberculosis.
  • Tell your doctor if you have a current infection.

A Step Forward in Medicine

Many biologic agents have been approved by the FDA. Many more are being developed.

Examples of Approved Biologic Agents for Autoimmune Disorders

Biologic Agent

Disease State

alefacept

psoriasis

ustekinumab

psoriasis

etanercept

psoriatic arthritis; rheumatoid arthritis; juvenile rheumatoid arthritis and more

adalimumab

rheumatoid arthritis, Crohn's disease, psoriasis and more

infliximab

rheumatoid arthritis; Crohn’s disease; ulcerative colitis

anakinra

rheumatoid arthritis

interferon beta

multiple sclerosis

certolizumab

Crohn's disease; rheumatoid arthritis; psoriatic arthritis

vedolizumab

Crohn's disease; ulcerative colitis

RESOURCES:

National Multiple Sclerosis Society
http://www.nationalmssociety.org

National Psoriasis Foundation
http://www.psoriasis.org

CANADIAN RESOURCES:

Health Canada
http://www.hc-sc.gc.ca

Healthy U
http://www.healthyalberta.com

REFERENCES:

Autoimmune diseases fact sheet. Office on Women's Health website. Available at: http://www.womenshealth.gov/publications/our-publications/fact-sheet/autoimmune-diseases.html. Updated July 16, 2012. Accessed June 24, 2016.

Biologic disease-modifying antirheumatic drugs (DMARDs) for rheumatoid arthritis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 9, 2014. Accessed July 18, 2014.

Donahue KE, Gartlehner G, Jonas DE, et al. Systematic review: comparative effectiveness and harms of disease-modifying medications for rheumatoid arthritis. Ann Intern Med. 2008; 148.

Efalizumab (marketed as Raptiva) information. US Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm133337.htm. Updated July 10, 2015. Accessed June 24, 2016.

Keystone EC, et al. Once-weekly administration of 50 mg etanercept in patients with active rheumatoid arthritis: results of a multicenter, randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2004;50(2):353-63.

Moderate to severe psoriasis: biologic drugs. National Psoriasis Foundation Web site. Available at: http://www.psoriasis.org/sublearn03_severe_biologics. Accessed June 24, 2016.

National drug code directory. US Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/InformationOnDrugs/ucm142438.htm. Updated April 22, 2016. Accessed June 24, 2016.

Last reviewed June 2018 by Michael Woods, MD  Last Updated: 7/3/2018