Biologic Therapy

Emirates Society for Rheumatology

Biological therapy is a relatively newer class of drugs used in treatment of a number of autoimmune conditions such as rheumatoid arthritis, Ankylosing spondylitis and Psoriatic arthritis. They are also used in other conditions such as skin Psoriasis, Crohn’s and Ulcerative colitis and Uveitis. Biologics work by dampening certain immune system signals that cause inflammation and damage of joint and other tissues. They have specific targets in immune system such as TNF Alpha, IL 17a, B and T lymphocytes etc. These modern therapies have dramatically improved treatment options for many people and revolutionized the outcome of these diseases. Used earlier in the course of disease, they can achieve quick and long term remission, prevent progression and damage to the joints. Unlike older disease-modifying anti-rheumatic drugs (DMARDs), biologics are made using biotechnology. They are genetically engineered to act like natural proteins in your immune system.

Biologics don’t cure RA, but they can dramatically slow its progression. They also cause fewer side effects than older drugs. People who don’t respond to older RA drugs, such as methotrexate, may benefit from treatment with a biologic. Sometimes biologics may be given alone. Other times they may be given in combination with another type of drug. Taking a biologic drug with methotrexate is most effective treatment for people with very active disease. Many of the biologics are available and widely used in UAE for autoimmune rheumatic conditions. Their main indication is for active disease that is unresponsive to standard conventional therapy such as Methotrexate. They are generally administered as injections as they cannot be absorbed by human gut wall. Some of them are considered safer in young women considering pregnancy with active disease. However, they need to be carefully monitored and hence can be taken only under supervision of specialists such as Rheumatologists, Gastroenterologists and Dermatologists. Some of the currently approved and available Biologics are Adalimumab (Humira), Etanercept (Enbrel), Infliximab (Remicade), Golimumab (Simponi), Certolizumab (Cimzia), Secukinumab (Cosentyx), Tocilizumab (Actemra), Abatacept (Orencia), Rituximab (Mabthera), Belimumab (Benlysta) etc. There are also newer treatments that can be orally administered and have similar potency such as Biologics. Some of them are approved and available in UAE such as Tofacitinib (Xeljanz), Olumiant (Baricitinib) and Apremilast (Otezla).

For further advice and eligibility, kindly discuss with your doctor.