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Biologic Therapy – Drug Options for Clients with Rheumatoid Arthritis

Clients with Rheumatoid Arthritis (RA) unresponsive to Disease-Modifying Medications (DMARDs) and other commonly prescribed drugs may benefit from biologic response modifiers or biologics. Biologic agents are drug therapies for clients with moderate to severe Arthritis. Unlike traditional RA medications, biologics target specific areas in the immune system decreasing inflammatory response and joint pain. Biologics can be administered alone or in combination with other pharmaceuticals. WebMD comments on biologic therapy stating, “Biologics are genetically-engineered proteins derived from human genes. They are designed to inhibit specific components of the immune system that play pivotal roles in fueling inflammation, which is a central feature of rheumatoid arthritis.” Biologics have been a breakthrough in managing RA for clients who have seen little if any improvement with traditional drug therapies.

A Deeper Look Into Biologic Agents:

Most biologics are administered through injection or intravenous infusions with the exclusion of tofacitinib (Xeljanz®), which is given orally. Johns Hopkins Medicine – Arthritis Center elaborates on clinical studies on tofacitinib commenting, “RA patients clearly demonstrated a clinical response with tofacitinib compared to placebo in these trials with improvement in the number of painful and swollen joints.” Other biologic agents include: Actemra, Cimzia, Enbrel, Humira, Kineret, Orencia, Remicade, Rituxan, and Simponi.   

Commonly Prescribed Biologics:

Tofacitinib (Xeljanz®): Is an oral JAK inhibitor preventing enzymatic reactions leading to immune responses in clients with RA. As noted by Johns Hopkins Medicine – Arthritis Center, “Tofacitinib (Xeljanz®) is the first of a unique class of oral kinase inhibitors to be FDA approved for the treatment of rheumatoid arthritis (RA)”. Johns Hopkins Medicine – Arthritis Center goes on to share how inhibiting JAX enzymes disrupts cytokines, which are contributors to the immune response seen in clients with RA.

Actemra: Is an interleukin-6 inhibitor that decreases inflammatory response. Actemra is given by injection or through intravenous infusions.

Cimzia, Enbrel, Humira, Remicade & Simponi: These drugs are administered through injections. Drug mechanism of action is to block tumor necrosis factor (TNF) reducing joint inflammation.

Kineret: Decreases inflammation by blocking interleukin-1, and given as daily injections.

Orencia: Blocks T-cells needed in the immune response that leads to inflammation. Orencia is administered through injections or intravenous infusions.

Rituxan: Is given through intravenous infusions when RA symptoms are not improved with TNF blockers (Cimzia, Enbrel, Humira, Remicade & Simponi). WebMD provides greater insight on Rituxan noting, “Rituxan is an antibody protein that works by targeting and reducing the number of specialized white blood cells, called B cells, in the blood.”

Visit WebMD for more information on commonly prescribed biologics.   

* All information shared in this article should be discussed with your healthcare practitioner prior to incorporating any suggestions. This article is for informational purposes only, and is not intended to provide advice or direct client decisions.

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Yeneilyn is a Registered Nurse in the state of Florida since 2006. Her nursing practice began in the field of Cardiology at Mount Sinai Medical Hospital and expanded to care for clients in the Intensive Care Unit (ICU). She was provided the opportunity as LPN Instructor, which changed the course of her nursing career. She states, “Teaching nursing students expanded my view on positive influences nurses contribute beyond beside care. Nurses are central leaders in health education, client advocacy, and disease prevention.” Currently, Yeneilyn writes health articles and prepares Continuing Education (C.E.) courses for healthcare professionals. She continues her studies in the field of Nursing Education and evidenced-based nursing practice. In her free time she enjoys sharing time with family and friends.

For questions or topics of interest contact Nurse Yenny at:    




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