Rheumatoid arthritis (RA) is a chronic autoimmune disease that affects the joints, causing inflammation, pain, stiffness and, over time, irreversible joint damage, leading to loss of mobility and joint deformity.
Although there is no cure, advances in treatment have radically changed the prognosis for those who suffer from it, especially thanks to the emergence of biological drugs.
What are biological medicines?
Biological treatments are drugs developed using biotechnology that act specifically on key molecules involved in the immune system’s inflammatory response. Unlike traditional drugs, which have a more general effect, biological drugs act in a targeted manner, allowing for greater efficacy with fewer systemic adverse effects, i.e., throughout the body.
These drugs are usually administered subcutaneously or intravenously and are mainly recommended for patients who have not responded adequately to conventional treatments, such as methotrexate (medication).
Main types of biological drugs
There are several groups of biological drugs for RA, depending on the molecule they act on:
- Anti-TNF (tumour necrosis factor): such as adalimumab, etanercept, or infliximab. These are the most commonly used and have been shown to effectively reduce inflammation and slow down joint damage.
- Anti-IL-6: such as tocilizumab, which blocks the action of interleukin-6, one of the main substances responsible for the inflammatory process in RA.
- B-cell or T-cell inhibitors: such as rituximab or abatacept, which modulate the activity of certain lymphocytes involved in the immune response.
- JAK inhibitors (non-biological, but similar in function): Although not strictly biological, JAK inhibitors (such as tofacitinib or baricitinib) are a highly effective oral alternative for patients with moderate to severe RA.
How have they changed RA treatment?
The incorporation of these treatments has been a true revolution. In the past, many patients suffered progressive and irreversible disability. Today, with early diagnosis and thanks to the wide range of treatments available, clinical remission or at least significant control of the disease can be achieved, thus significantly improving quality of life.
In addition, a treatment approach known as ‘treat to target’ has been adopted, which involves adjusting medication until a clear therapeutic goal is achieved, such as remission or low disease activity.
Important considerations
Although biological medicines have been proven to be safe and effective, their use requires close monitoring. By modulating the immune system, they can increase the risk of infections, so it is important to undergo regular check-ups and follow the recommended vaccination schedule.
In summary, biological treatments have transformed the treatment of rheumatoid arthritis, offering new hope to thousands of patients worldwide.
Dr. Antonio Avilés
Rheumatology Resident
Dr. Balmis General Hospital
