These are the newest range of disease-modifying drugs for rheumatoid arthritis. You may also hear them called cytokine modulators or monoclonal antibodies.
How they work: They mimic substances produced by the human body such as antibodies, and, like the DMARDS above, act by blocking chemicals involved in the inflammation process. Some of the drugs block a chemical called TNF-alpha, and so may also be referred to as anti-TNF drugs.
Biologicals are also sometimes used to treat other inflammatory conditions such as psoriatic arthritis, juvenile idiopathic arthritis, and Crohn’s disease.
Who gets them?Whilst these drugs can be very effective, they need to be given by injection or infusion, and they are also expensive.
Recent guidelines from NICE* (National Institute for Health and Clinical Excellence), state that patients should have high levels of persistent disease activity, and have failed on two traditional DMARD drugs either singly or combination therapy (at least one including methotrexate unless contraindicated) taken for at least six months. Biological medicines may also be used in combination with methotrexate (a DMARD).
* NICE TA375, Jan 2016
Examples of biologicals include:
For more detailed information see the leaflet: Medications in Rheumatoid Arthritis from NRAS