Biologic Therapies 101

September 13, 2018 by Vikram Sengupta, MD0

Introduction:

Biologic therapy is a form of clinical treatment that promotes the human body’s own defense system, i.e. immune system, to fight disease.  Revolutionary advancements have been made in the last thirty years in both the understanding of the immune system as well as the development of new biologic therapies.

How Does It Work?

Biologic therapies are designed to mimic and function as antibodies, which are special proteins that are naturally produced by the immune system to battle against infection.  These antibodies target specific molecules of interest.   For example, Remicade binds to and inactivates a molecule called Tumor Necrosis Factor (TNF-alpha)–since TNF-alpha is a key chemical messenger in many auto-immune disorders, Remicade has shown significant results in terms of inducing and maintaining remission in patients with Crohn’s Disease, Ankylosing Spondylitis, Psoriatic Arthritis, Plaque Psoriasis, and Rheumatoid Arthritis.

How Should It Be Administered?

Biological therapies are prescribed by specialists, including rheumatologists, gastroenterologist, neurologists and hematology-oncologists as patient selection is crucial.  Labs may be obtained to confirm that the patient is not immunocompromised prior to the infusion.   Infusions, especially first-time infusions, should be administered by an experienced infusion nurse so that the patient can be monitored and treated for side effects, which may include chills, fever, muscle aches, and nausea.  Duration and frequency of infusion varies depending on the specific biologic therapy.  In the days following the completion of the infusions, phone calls are made to verify patient safety and comfort in addition to updating the referring specialist.

Future Potential?

The future of biologic therapies is promising as the antibodies can be designed against an unlimited number of targets.  Existing therapies have already shown significant results in terms of limiting disease progression, providing hope for patients with otherwise refractory disease.


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