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New Treatments Stop RA in Its Tracks

By Greenfield, Paige
Content provided by: Better Medicine from Healthgrades

There are a slew of medications that help treat the symptoms of rheumatoid arthritis (RA), as well as the disease itself. If you have RA, you've probably tried many of them. Now, there's another category of drugs called biologic agents that are giving many people even more hope. They work successfully in about two-thirds of people with RA, leading to remission in most of them.

What are biologic agents?

Whereas other drugs are made from chemicals, biologic agents are genetically engineered from a living organism such as a virus, gene, or protein and then used to treat health issues in humans. Although they may sound like something out of a sci-fi movie, the results are very real.

RA occurs when the body's immune system attacks the lining of your joints, causing inflammation that results in pain, swelling, and stiffness. Biologic agents work by blocking parts of the immune system that are involved in the inflammation process.

Each type of biologic agent blocks a specific step in the inflammation process. Some block proteins or chemicals that trigger inflammation. Others stop the activation of a certain kind of white blood cell. This helps reduce the activity of the immune system, which is overactive in people with RA.

Biologic agents approved to treat RA include:

  • Abatacept (Orencia)

  • Adalimumab (Humira)

  • Anakinra (Kineret)

  • Certolizumab (Cimzia)

  • Etanercept (Enbrel)

  • Golimumab (Simponi)

  • Infliximab (Remicade)

  • Rituximab (Rituxan)

  • Tocilizumab (Actemra)

How are biologics administered?

The following biologic agents are given subcutaneously, which means under the skin. You can administer them at home.

  • Abatacept is injected once a week.

  • Adalimumab is injected every two weeks. 

  • Anakinra is a daily injection.

  • Certolizumab is injected every two to four weeks.

  • Etanercept is injected once or twice per week.

  • Golimumab is injected once a month.

The following medications are taken intravenously, which means through a vein, at a doctor's office or an infusion center.

  • Abatacept takes about 30 minutes per dose and is given every two weeks for the first three doses and then every four weeks. Abatacept is available as both an infusion and a self-injection, as noted above.

  • Infliximab is given during a two-hour procedure every two to eight weeks.

  • Rituximab is given over several hours. You may receive two doses with two weeks between each one.

  • Tocilizumab is given over one hour. It's usually given every four weeks.

Are they right for you?

Your doctor might start you on biologic agents, sometimes in combination with other medications, soon after diagnosing you with RA. Treating the condition as soon as possible may help prevent permanent joint damage. On the other hand, your doctor might suggest them only after other treatments have failed. That's because biologic agents work by suppressing the immune system, which can increase your risk for infection and other health problems. Talk with your doctor about whether biologic agents might be right for you. 

Medical Reviewer: McDonough, Brian, MD
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Reference: Rheumatoid Arthritis section on Better Medicine

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