The immune system plays a vital role in keeping the body healthy. It is made up of a complex network of cells and organs that work together to defend the body against foreign invaders.
Biologic agents use the body’s own immune system to help fight disease. While traditional pharmaceuticals are made up of chemicals, biologic agents are actually developed using proteins from living cells. They are designed to act on different parts of the inflammatory system in order to evoke specific, targeted effects.
In autoimmune disorders, the immune system is overactive and destroys not only foreign substances, but also the body’s own tissues. The goal of biologic therapy is to slow or block specific components of the immune system and halt tissue destruction.
Autoimmune disorders treated with biologic agents include:
Because biological agents are very specific in their targets and more precise and predictable, they tend to produce fewer side effects and undesirable consequences than traditional medicines, which are manufactured through synthetic chemical means.
Side effects depend on many factors such as the type of biologic, dosage, route of administration, schedule, and how your body reacts to the biologic agents. Some of the most common side effects of biologic therapies are:
Many biologic agents have been approved by the FDA (see the following table), and many more are under development.
Examples of Approved Biologic Agents for Autoimmune Disorders | ||
|---|---|---|
Brand name | Biologic Agent | Disease State |
Amevive | psoriasis | |
Raptiva * | efalizumab | psoriasis |
Stelara | ustekinumab | psoriasis |
Enbrel | psoriatic arthritis; rheumatoid arthritis; juvenile rheumatoid arthritis and more | |
Humira | rheumatoid arthritis, crohn's disease, psoriasis and more | |
Remicade | rheumatoid arthritis; Crohn’s disease | |
Kineret | rheumatoid arthritis | |
Avonex, Rebif | multiple sclerosis | |
* In April 2009, the manufacturer of efalizamab (Raptiva) voluntarily decided to remove it from the market. The medicine has been linked to a rare brain infection that can be life-threatening. If you are currently taking Raptiva, talk to your doctor about other treatments.
RESOURCES:
National Multiple Sclerosis Society
http://www.nationalmssociety.org/
National Psoriasis Foundation
http://www.psoriasis.org/
The Arthritis Foundation
http://www.arthritis.org/
CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca/index_e.html/
Healthy U
http://www.healthyalberta.com/
References:
Biologics. National Psoriasis Foundation Web site. Available at: http://www.psoriasis.org/research/biologics. Accessed on: February 27, 2004.
Cambridge G, Leandro MJ, Teodorescu M, et al. B cell depletion therapy in systemic lupus erythematosus: effect on autoantibody and antimicrobial antibody profiles. Arthritis Rheum. 2006; 54:3612.
Donahue KE, Gartlehner G, Jonas DE, et al. Systematic review: comparative effectiveness and harms of disease-modifying medications for rheumatoid arthritis. Ann Intern Med. 2008; 148.
Drugs and Supplements. Mayo Clinic.com website. Available at: http://www.mayoclinic.com/health/drug-information/DrugHerbIndex. Accessed November 15, 2010.
Gottlieb AB. Infliximab for psoriasis. J Am Acad Dermatol. 2003;49(2 Suppl):S112-S117.
Keystone EC, et al. Once-weekly administration of 50 mg etanercept in patients with active rheumatoid arthritis: results of a multicenter, randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2004;50(2):353-63.
Krueger JG. The immunologic basis for the treatment of psoriasis with new biologic agents. Journal of the American Academy of Dermatology. 2002:46(1);1-23.
Lus G, et al. Azathioprine and interferon beta(1a) in relapsing-remitting multiple sclerosis patients: increasing efficacy of combined treatment. Eur Neurol. 2004;51(1):15-20.
Noble J, ed. Textbook of Primary Care Medicine. 3rd ed. St. Louis, MO: Mosby, Inc; 2001.
Psoriasis drug Raptiva pulled from US market. Health Day News, EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81. Published April 9, 2009. Accessed July 29, 2008.
What are biologic response modifiers? The Arthritis Foundation Web site. Available at: http://www.arthritis.org/AFSStore/StartRead.asp?idProduct=3337. Accessed on: February 27, 2004.
Last reviewed June 2010 by Brian P. Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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