Biologics – An Overview

Abstract

The biologics used in inflammatory arthritis are genetically engineered proteins derived from human genes. They inhibit specific components of the immune system, which play pivotal roles in driving or inhibiting inflammation in arthritis. Unlike conventional drugs that modify the immune system as a whole, biologics affect specific components of the immune system. Theoretically this targeted approach is both more specific in its effects and causes fewer adverse events. However, in reality the complex interactions of cytokines and the multiplicity of cytokine targets means it is difficult to predict the effectiveness and toxicity of cytokine-based interventions such as biologics. There are currently six different classes of biologics available for the treatment of inflammatory arthritis patients. Each inhibits a different aspect of the immune driven inflammatory pathway. This chapter will provide a broad overview of the available biologics, the current treatment pathways dictating their prescribing in the UK and the health economics issues surrounding their use.