Rheumatoid Arthritis Medication

Biologic Response Modifiers

Biologic response modifiers are the newest medications for rheumatoid arthritis. These medications selectively block parts of the immune system called cytokines. Cytokines play a role in inflammation. The long-term efficacy and safety of these drugs are uncertain.

 

Side effects can include an increased risk of infection (especially tuberculosis), pneumonia, and listeriosis (a food borne illness caused by the bacterium Listeria monocytogenes).

 

It is important to avoid eating undercooked foods (including unpasteurized cheeses, cold cuts, and hot dogs) because undercooked food can cause listeriosis for patients taking biologic response modifiers.

 

Three types of biologic response modifiers include:

 

There are several types of tumor necrosis factor (TNF) inhibitors used for rheumatoid arthritis treatment. These include:

 

These medications are highly effective at treating patients with an inadequate response to DMARDs. They may be prescribed in combination with some DMARDs, particularly methotrexate. Etanercept requires subcutaneous (beneath the skin) injections one or two times per week. Infliximab is taken intravenously (IV) during a two-hour procedure; it is administered with methotrexate. Adalimumab requires injections every two weeks. The long-term efficacy and safety of these drugs are uncertain.

 

Enbrel side effects can include: pain or burning in the throat; redness, itching, pain, and/or swelling at the injection site; and runny or stuffy nose.

 

Remicade side effects can include: abdominal pain (or stomach pain), cough, dizziness, fainting, headache, muscle pain, runny nose, shortness of breath, sore throat, vomiting, and wheezing.

 

Humira side effects can include: redness, rash, swelling, itching, bruising, sinus infection, headache, and nausea.

 

Long-term efficacy and safety are uncertain. Doctor monitoring is important, particularly if you have an active infection, exposure to tuberculosis, or a central nervous system disorder. Evaluation for tuberculosis is necessary before treatment begins.