Rheumatoid arthritis (RA) is a chronic inflammatory condition that affects major joints of the body, especially those of the hands and feet. It is an autoimmune condition and there is no cure for the disorder. In severe cases of RA, the diseases start attacking the internal organs as well. In most cases, RA affects the joint linings, leading to painful swelling. Over a period of time, this inflammation can lead to joint deformity and bone erosion. The treatment for RA or Rheumatoid arthritis revolves around the management of symptoms. Biologics is one of the more recent treatments that is today used frequently for treating RA or Rheumatoid arthritis. However, before the advent of biologics, it was common for people having RA to suffer from severe joint deformity. Here’s all you need to know about rheumatoid arthritis, joint damage, and biologics.
What is Rheumatoid Arthritis (RA)?
RA is an autoimmune condition that affects the joints of the body, causing pain and damage throughout the body. RA typically causes joint damage that happens on both sides of the body. So if you have a joint affected by rheumatoid arthritis or RA on one of your legs or arms, it is likely that the same joint will also get affected on the other leg or arm. This is one of the major distinguishing factors of RA or Rheumatoid arthritis from other types of arthritis, especially osteoarthritis.
Being a chronic disease, RA symptoms are typically pain and inflammation in the joints. These symptoms tend to occur during periods referred to as flares, during which the severity of the symptoms increases. Then there is a period of remission, during which the symptoms dissipate totally. Some of the symptoms of RA or Rheumatoid arthritis may include:
- Joint pain
- Joint stiffness
- Joint swelling
- Loss of joint function
RA or Rheumatoid arthritis symptoms can either be mild to moderate or in some cases, extremely severe. It is important that you do not ignore your symptoms, even if they come and go randomly.
Before the advent of biologics, people suffering from RA or Rheumatoid arthritis used to often face a future of joint deformity. This is not to say that joint destruction and deformities don’t occur anymore, but treatment with biologics makes it possible to halt or at least slow down the progression of the disease, delaying joint damage and deformities.
Recent years has seen a profound change in the treatment of RA or Rheumatoid arthritis, with the introduction of several new treatments. However, while biologics have significantly improved the quality of life for RA patients, biologics also carry their own risks and side effects.
Biologics and RA
The entry of biologics revolutionized the treatment of RA as biologics began to target the specific cells within the immune system that had a role to play in the presentation and progression of the disease. With the availability of these precise and targeted disease management efforts, RA or Rheumatoid arthritis patients who got treated with biologics experienced a reduction in bone involvements and also suffered from less destruction of the joint cartilage and synovial tissue.
Biologic drugs work by mimicking antibodies that are naturally produced by the body. This is a different way of treatment as compared to the usual medications that are manufactured from chemicals. The substances present within the biologic medications prohibit specific components of the immune system that are known to cause inflammation. This method of treatment is also different from the earlier anti-inflammatory drugs that were used for the treatment of RA. However, while biologics are much more effective at treating RA than the earlier medications, they are not always considered to be safe for use.
Treating RA with biologics can help in improving flare-ups and also prevent joint deformities, but they will not help you get relief with everything. People who are on biologics still live with many of the other symptoms that are associated with RA or Rheumatoid arthritis, including fatigue. Even though the goal of treating RA with biologics is to prevent or delay joint deformity, there is still no guarantee of that happening. Biologics only increase the likelihood of preventing joint deformity.
Benefits of Treating RA with Biologics
There is no formal literature available on how to introduce biologics into an RA treatment plan. However, most rheumatologists tend to agree that there are many benefits associated with using biologic drugs for treating and managing the symptoms of RA or Rheumatoid arthritis.
One of the first biologic drugs that were approved for the treatment of RA or Rheumatoid arthritis were TNF-inhibitors or anti-tumor necrosis factor inhibitors. These drugs include:
- Remicade (infliximab)
- Enbrel (etanercept)
Research, though, has only been able to prove the efficiency of these biologic medications for the short-term. However, it has been observed that a huge percentage of RA patients end up developing acquired drug resistance to these biologic agents.
A study done by the University of Michigan in the United States found that using DMARDs (disease-modifying anti-rheumatic drugs) along with biologic DMARD therapy can provide better results in improving the functioning of the affected joints and also in reducing further destruction of the affected joint. However, at the same time, this study warned about the use of biologics coming with several side effects as well as long-term risks.
Most medical experts agree that the maximum amount of joint damage in RA patients already occurs early on in the disease, usually within the first two to three years itself. This is why doctors are now preferring to put patients on biologic drugs early on in the treatment plan.
Treatment with biologics can prevent or delay some amount of joint damage from taking place. Joint damage in RA patients is generally caused by the inflammation, thus this is the one component of RA or Rheumatoid arthritis that needs to be controlled well from the outset itself.
At the same time, there is no evidence that shows that NSAIDs (nonsteroidal anti-inflammatory drugs), which were once the first line of defense in treating RA or Rheumatoid arthritis, can effectively manage the inflammation that stems from this condition.
Risks Associated with Biologics
Before deciding to begin treatment with biologic drugs, RA patients need to carefully weigh both the benefits and risks associated with these medications. Many of these biologic drugs carry an increased risk of many serious side effects, including:
- Higher risk of infection, especially tuberculosis and fungal infections
- Increased risk of certain types of cancers, especially with long term use
- Circulatory or cardiovascular problems
However, the vast evidence that proves the many benefits if biologics, though, is usually enough to persuade doctors and patients to opt for treating with biologic drugs, especially in the early stages of moderate to severe RA.
What Biologic Drugs are Available for Treating RA?
There are several types of biologic medications available on the market today for treating many conditions, one of which is RA. Some of the commonly used biologics in the treatment of RA or Rheumatoid arthritis include:
- Rituxan (rituximab)
- Orencia (abatacept)
- Remicade (infliximab)
- Kineret (anakinra)
- Humira (adalimumab)
- Actemra (tocilizumab)
- Xeljanz (tofacitinib)
- Simponi (golimumab)
Biosimilars have also been introduced into the market now and these are less expensive versions of biologics. The two commonly used biologicals for treating RA are Inflectra and Zarxio.
If you want to consider treating your RA with biologic drugs and prevent your condition from progressing to a stage where joint deformity is likely to happen, then it is recommended that you speak with your doctor and find out all you can about these medications, how they work, and their potential side effects. Making an informed decision, keeping the risks of biologic drugs in mind, will help you stay aware of your treatment plan. There is no doubt that biologic drugs have been found to immensely benefit the symptoms of RA or Rheumatoid arthritis and has also shown promising results in preventing or delaying the progression of the disease.
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