Biologic drugs are a special, complex class of medications. Unlike typical drugs and medications that are made from synthetic chemicals, biologic drugs are derived from human and animal cells. Biologic drugs may treat a variety of conditions, but this article will focus on biologics used to treat types of spinal inflammatory arthritis, such as rheumatoid arthritis, juvenile rheumatoid arthritis, and ankylosing spondylitis.
How Biologics Work
Biologic drugs fall into four types: tumor necrosis factor (TNF) inhibitors, B-cell inhibitors, interleukin (IL) inhibitors, and T-cell inhibitors. Regardless of the type, biologics for spinal inflammatory arthritis work by restoring the healthy function of your immune system.
To do this, biologic drugs treat specific parts of your immune system using biological response modifiers (BRMs) created by the immune system. In the case of spinal inflammatory arthritis, biologics interfere with a protein in the immune system that causes joint inflammation.
BRMs are naturally released by your body in small amounts in response to disease. Biologic drugs essentially contain larger amounts of BRMs to provide your body with an extra line of defense.
Biologic agents must be injected. While some biologics are injected under the skin (allowing you or a family member to inject the drug), others must be injected through a vein by a medical professional at a health care facility.
Biologics and Disease-Modifying Anti-Rheumatic Drugs
Traditional disease-modifying anti-rheumatic drugs (DMARDs) are a class of medication commonly prescribed to manage spinal inflammatory arthritis. But, if DMARDs prove ineffective, your doctor may recommend a biologic as a next step. Biologics are actually a newer generation of DMARD. As such, your doctor may refer to them as biologic DMARDs.
While it may take more than a month for a traditional DMARD to take effect, biologics work quicker—some within 2 weeks.
Biologics can be used alone but are often taken in conjunction with traditional DMARDs to increase the benefits. However, biologics should not be used with other biologics. Make sure to talk to your doctor about all medications and supplements before starting biologic drug therapy.
Types of Biologic Drugs for Spinal Inflammatory Arthritis
In 1998, etanercept became the first biologic approved for rheumatoid arthritis. Below are biologic drugs currently approved to reduce symptoms associated with spinal inflammatory arthritis:
Potential Side Effects of Biologic Drugs
Before starting a biologic, your doctor will have you screened for infections, particularly tuberculosis, to ensure you are healthy to begin therapy. Biologics suppress your immune system, so you will be at a greater risk of developing an infection or disease if you are taking them.
Other side effects include nausea, vomiting, muscle aches, weakness, loss of appetite, and fever. Depending on the type of biologic you are taking, you may experience additional side effects related to that particular drug.
Since biologics are a newer class of medication, many of the long-term side effects aren't fully understood. That's why a doctor's supervision is essential when using a biologic drug, especially if you have an active infection, central nervous system disorder, or are exposed to tuberculosis.
Biologics Versus Biosimilars
Because biologics are made with living cells and not chemicals, generic equivalents are not possible. However, a biologic alternative known as biosimilars are hitting the market to offer additional therapeutic options and increase access to people who could benefit from these drugs. One example of the growing biosimilar industry is the 2016 FDA approval of Erelzi for spinal inflammatory arthritis.
As the name suggests, a biosimilar is very similar to an approved biologic drug, but it’s not an exact replica. That’s what makes a biosimilar different from a generic drug, which has identical active ingredients to its brand-name counterpart. Because biologic drugs are so complex, they are unable to be have an identical match.
Generic drugs are sought after for their low cost, and biosimilars are designed to be more affordable compared to biologics. But, biosimilars are not expected to drive as much cost savings as generic drugs, as they do take considerable time and money to develop.
Achieving Success with Biologic Therapy for Spinal Inflammatory Arthritis
Biologic drugs are advanced and innovative medications that may provide pain relief for people with spinal inflammatory arthritis conditions—from rheumatoid arthritis to ankylosing spondylitis. As with all medications, biologics may have side effects or adverse interactions with other drugs. Discuss all medications—even if they're over-the-counter and pose no apparent risk—with your doctor before starting this therapy.