These biologic response modifiers block an immune system protein called tumor necrosis factor, which acts as an inflammatory agent in some types of arthritis. By targeting this protein, TNF blockers can help reduce pain, morning stiffness and swollen joints. Some people experience side effects during or shortly after these drugs are injected, including chest pain, dizziness and difficulty breathing, as well as redness, itching and swelling at the injection site. Additional side effects of biologic response modifiers may include abdominal pain, headache, respiratory infections such as tuberculosis, and other infections. These medications also may increase your risk of demyelinating disorders, conditions that damage the protective covering (myelin sheath) that surrounds nerves in your brain and spinal cord.Enbrel, Humira, and Remicade (Revelex in South Africa) inhibit a cytokine called tumor necrosis factor or TNF. Kineret blocks the cytokine interleukin-1 (or IL-1). Rituxan (Mapthera) selectively targets immune cells known as CD20-positive B cells.
Enbrel (Etanercept)
Enbrel reduces joint inflammation by blocking a cytokine called tumor necrosis factor, or TNF. Enbrel is given by self-injection under the skin once or twice a week. Many people learn to give their own injections or receive them from a family member who has received proper instruction. A kit is available from the manufacturer that makes drawing up the medicine and injecting it easier. Enbrel may cause irritation at the injection site, which is diminished by applying a cold pack to the injection site prior to injection. Enbrel's effect can also weaken the immune system. Although rare, some people have developed serious infections while taking Enbrel. Anyone with a serious infection should stop taking Enbrel and resume it after being advised by a doctor. If you develop an infection, let your doctor know immediately as you need to be monitored closely. Pregnant women should not take Enbrel because the effects on a developing child are unknown.
Enbrel reduces joint inflammation by blocking a cytokine called tumor necrosis factor, or TNF. Enbrel is given by self-injection under the skin once or twice a week. Many people learn to give their own injections or receive them from a family member who has received proper instruction. A kit is available from the manufacturer that makes drawing up the medicine and injecting it easier. Enbrel may cause irritation at the injection site, which is diminished by applying a cold pack to the injection site prior to injection. Enbrel's effect can also weaken the immune system. Although rare, some people have developed serious infections while taking Enbrel. Anyone with a serious infection should stop taking Enbrel and resume it after being advised by a doctor. If you develop an infection, let your doctor know immediately as you need to be monitored closely. Pregnant women should not take Enbrel because the effects on a developing child are unknown.
Humira (Adaluminab)
Humira also blocks the cytokine tumor necrosis factor. The drug is an injection that can be self-administered. It is usually taken once every two weeks. Rare cases of severe allergic reactions and blood cell deficiencies have occurred with Humira. Bruising or bleeding can be a sign of blood cell problems and should be reported to your doctor immediately. In addition, serious infections have been seen in clinical trials when Humira was taken with the rheumatoid arthritis drug Kineret.
Kineret
Kineret reduces joint inflammation by blocking the cytokine interleukin-1. The drug is administered as one injection daily (can be self-injected or given to you by another individual). This is generally not widely used in practice because of low effectiveness rates. Tell your doctor if you develop signs of an infection, such as fever.
Revelex (infliximab)
Like Enbrel and Humira, Revelex reduces inflammation by blocking the cytokine tumor necrosis factor. Revelex is given by intravenous infusion in the doctor's office or hospital. Each infusion takes about two hours. The intravenous treatments are given three times during the first six weeks of therapy, then every eight weeks. Revelex is given with methotrexate for treating RA. As with other biologics, treatments may weaken the body's ability to fight infection. If you have any signs of infection such as a fever over 100 degrees F, sweats or chills, skin rash, or other symptoms that cause concern, contact your doctor right away.
With any treatment, it is important to meet with your doctor regularly so he or she can closely monitor you to detect the development of any side effects and monitor your treatment if necessary. Your doctor may periodically order blood tests or other tests to determine the effectiveness of your treatment and the presence of any side effects.
Rituxan (Mapthera)
Rituxan is approved for patients with moderate-to-severe RA who have not improved with TNF antagonists, such as Enbrel or Remicade. Rituxan is given as two infusions in the vein -- separated by two weeks -- in combination with weekly methotrexate. The most common side effects include infections and reactions while the medicine is given (called infusion reactions). Symptoms of infusion reactions include flu-like illness, fever, chills, nausea, and headache.
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