Unlike most of the categories on the menu of treatment options when you’re choosing a clinical trial on the FindMeCure website, “biologics” is not immediately understood. While we all know what “device” means in terms of medical treatment and what “behavioral” might imply, biologics are not that easy and intuitive to grasp unless you have some sort of medical background or are extensively informed by your doctor. Nevertheless, you need to make a choice of treatment even if you’re not looking to get involved in a clinical trial, so we’d like to make it as easy on you as possible and spare you all the daunting and incomprehensible medical explanations.

So, what are biologics? Well, apart from being “the cutting-edge” of medical research and the potential answer to a lot of currently untreatable diseases (there’s much hope in them), biologics are not that hard to comprehend once you get to the core principle. The simplest explanation is that biologics are modified proteins (could also be sugars or nucleic acids). Unlike most drugs, which are chemicals derived from other chemicals, biologics are manufactured with the use of living microorganisms or cells – a much more complex process and… well, more expensive.

Of course, it’s actually a bit more complicated than that and there are different types of biologics, depending on the way they were isolated and modified. But if all of it sounds alien to you, let’s give you just one example: vaccines. They have been around for a long time now and we all know the basic principle most of them work on. Bottom line is, both new and “old” generations of biologics are in some way derived from living organisms. But if you’re interested in the process in more detail, you can check out this article EverydayHealth, which also explains why there are no generic biologicals in the US as of now.c

Nowadays biologics are used for a variety of different conditions, including some types of cancer. And they show a lot of promise for rheumatoid arthritis especially, as most of the top 10 biologic meds in the USA are used for the treatment of RA[1]. The first biological drug for RA, etanercept (Enbrel), was approved for use in 1998 and since then 9 more got the thumbs up from the FDA.

The reason biologics get so much hype when it comes to RA is because they target specific parts of the immune system which play role in inflammation, unlike regular non-biologic drugs, which have a more broader scope. Jeffrey Curtis, MD and director of Arthritis Clinical Intervention Program at the University of Alabama, compares biologics to snipers when it comes to fighting the war against RA – they “take out” particular targets. The thing is, no one can tell yet which one is the right target in any given case, and it likely depends on the individual patient. Some specialists argue that adding biologics to RA treatment makes very little difference in terms of effectiveness but it poses greater safety hazard.

A 2004 study at Stanford University seems to reinforce this claim: no benefit was found when biologics were used alongside non-biologic drugs, but there was an increased risk of infections and lower white blood cells count[2]. And though biologics are different kinds, they all share the risk of infection, like any drug which suppresses the immune system.

However, there are some contradictory claims and mixed reactions, acknowledging the risk of infections, but also praising the efficacy of biologics in treating RA and advancing understanding of the disease itself. It’s no light subject to talk about, as there are many factors at play.

On the one hand, there is no telling who will respond how to a biologic treatment, as it’s not clear which “target” the biologic aims at is right for which patient, and there are many components behind an RA diagnosis – not just the ones a biologic can “attack”. On the other hand however, there are some claims that biologics significantly slow down the progression of RA and have fewer side effects compared to older drugs. And, if you don’t respond to the standard DMARDs treatment, biologics might be your only option.

How do I know if I’m taking a biologic?

We get it that in all the chaos of information, sometimes the words your doctor used at the end of your last appointment might be forgotten in favor of all the questions and worrisome thoughts going around your head. So, to make it easier on you, here’s a list of drugs which are undoubtedly biologics:
[1] https://www.thebalance.com/top-biologic-drugs-2663233

[2] http://www.arthritis.org/living-with-arthritis/treatments/medication/drug-types/biologics/drug-guide-biologics.php

Article by Nelly Katsarova

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