Sample Essays on The Use of Biologics in Rheumatoid Arthritis

The Use of Biologics in the Management of Rheumatoid Arthritis (RA)

Biologics can be described as medicines that are formulated using certain kinds of cells to create the right type of protein. Biologics can also be collected from several things in human body, for example, hormones and DNA. These constituents are afterward, for the most part, infused into the body since they would be destroyed in the digestive system. Biologic medicines, are given through injection or through intravenous infusion (Scott, 2012). A biologic is a protein-derived medicine obtained from living cells refined in a laboratory. Although biologics have been applied to treat illnesses for over 100 years, modern techniques have made these drugs much more largely accessible as treatments in the last ten years (Scott, 2012). Biologics differ from conventional systemic medicines that affect the whole immune system since they instead aim at definite parts of the system. In approximate, 300 biologics are now obtainable for human use and they are largely accepted as the most efficient method of treating certain illnesses such as cancer and rheumatoid arthritis (Scott, 2012). Biologics can be applied in treatment of rheumatoid arthritis that has ineffectively responded to other medications.

Creating a biologic medicine requires two fundamental conditions. Firstly, the cells in which the drug will be produced have to be grown in very large quantities. Large components of yeast or bacteria are required, and they have to be preserved under conditions that enable them to continue living and functioning normally (Scott, 2012). However, the second requirement is much more complicated since the cellular instructions of forming all proteins are transmitted by the DNA in the genetic materials. Therefore, if the right gene is either isolated or created, there would be a blueprint that would instruct the cell how to create the protein required. When the scientists obtain the correct gene, they apply other unique techniques to insert the genetic material into the DNA of the host cell. They begin with one normal cell and literally connect the new gene where it becomes integrated and permanent. They also insert some special bits that essentially inform the cell that this gene is vital and besides striving to stay alive, it should put all its other energies on following this gene’s instructions for producing the desired protein. This process makes the cell a definite protein-making mini-factory. The whole process, from obtaining the gene, to placing it into the cell, to producing huge quantities of the tailored cells, and lastly, to drawing just the desired protein without cellular contaminants is incredibly complex. This may require state-of-the art knowledge of molecular biology, biotech and cell culture skills, thereby making the drugs very expensive and the standard drug facilities, however sophisticated, are insufficient for biologic manufacture (Scott, 2012). Entire new facilities should be built and a wide variety of highly skilled scientists is required to figure out the biotechnology required.

The treatment of Rheumatoid Arthritis is aimed at obtaining the lowest possible illness activity and if possible remission. Biologic compositions that aim at specific components of the immune response are very useful in reducing RA indicators, reducing the rate of disease evolution, and enhancing physical function of life measures in people with moderate to severe Rheumatoid Arthritis (Scott, 2012). Dosing programs and routes of treatment differ depending on the type of the biologic used, and these factors control the cost of treatment and patient and doctor preference. Biologics can be applied in treatment of rheumatoid arthritis that has ineffectively responded to other medications. They differ considerably from conventional drugs used in the treatment of rheumatoid arthritis since they target exact constituents of the immune system rather than generally affecting many parts of the system. Biologics can be used alone although they are normally given together with other rheumatoid arthritis medicines and they have helped slow development of rheumatoid arthritis when all other medications have failed to do so (Scott, 2012). Aggressive rheumatoid arthritis management is known to help avert long-term disability that can be caused by the disease.

The most frequent side effect identified with biologic treatment is pain and irritation at the injection spot and this occurs in less than 30 percent of patients (Wolfe, and Michaud, 2007). Since biologics injected in the vein could possibly cause an allergic injection reaction, patients are closely observed during infusions. Symptoms of these reactions incorporate flu-like sickness, fever, coldness, queasiness, and headache. As with any medicines that restrain the immune system, treatment-involving biologics poses some increased danger to infections and other illnesses (Wolfe, and Michaud, 2007). People undergoing biologic treatment should try to find immediate medical attention if they develop constant fever or mysterious symptoms. Vaccinations that avert infections need to be well thought-out before undergoing biologic treatment and while taking these drugs people, should not be given live vaccines. Another side effect of biologics is that they may cause some chronic illnesses that are dormant such as tuberculosis to flare, and they are not commended for patients with multiple sclerosis and other sicknesses such as heart failure. It is therefore advisable for all patients to be skin tested for tuberculosis as well as chronic hepatitis before commencing with biologic treatment.

Numerous biologics have been approved for the management of RA. These include: Cimzia,Humira, Kineret, Orencia, Rituxan and Simponi among others (Singh, Furst, Bharat, Curtis, Kavanaugh, Kremer, Moreland, O’Dell, Winthrop, Beukelman, and Bridges, 2012). Since biologics are genetically-modified proteins drawn from human genes, they are designed to slow down specific elements of the immune system that take part in essential roles in stimulating inflammation, which is a key aspect of rheumatoid arthritis.

One drawback of biologic treatment is that they must be administered either through injection or through intravenous infusion, apart from Xeljanz, which is orally administered. Although animal experiments of biologics have not revealed any effect on fertility or health of the fetus, these studies cannot entirely predict the effects on human beings (Wolfe, and Michaud, 2007). Pregnant women are therefore recommended to receive this treatment only when considered necessary, because the impact on a developing child is unknown. Biologics medicines are usually discontinued before surgery until lesions have healed and the danger of infection is minimized.

Generally, an array of biologic treatment should not be taken all at once. With any treatment, it is important for the patients to meet with their doctor frequently to monitor their progress and to assess side effects. The physician may at times ask for blood tests or any other tests to investigate the effectiveness of the medicine and identify inner side effects. However, irrespective of the side effects, biologic medicines have greatly shaped the treatment of rheumatoid arthritis (Singh et al., 2012).



Scott, D.L., 2012. Biologics‐Based Therapy for the Treatment of Rheumatoid Arthritis. Clinical Pharmacology & Therapeutics, 91(1), pp.30-43.

Singh, J.A., Furst, D.E., Bharat, A., Curtis, J.R., Kavanaugh, A.F., Kremer, J.M., Moreland, L.W., O’Dell, J., Winthrop, K.L., Beukelman, T. and Bridges, S.L., 2012. 2012 Update of the 2008 American College of Rheumatology recommendations for the use of disease‐modifying antirheumatic drugs and biologic agents in the treatment of rheumatoid arthritis. Arthritis care & research, 64(5), pp.625-639.

Wolfe, F. and Michaud, K., 2007. Biologic treatment of rheumatoid arthritis and the risk of malignancy: analyses from a large US observational study. Arthritis & Rheumatism, 56(9), pp.2886-2895.