You may have so many questions about autoimmune disorder treatment, including biologic medications, after being diagnosed with one of the 80-plus types of autoimmune diseases. It’s a very important question, as your treatment plan will largely influence how you feel both mentally and physically on a daily basis.
Autoimmune disorders happen when your immune system mistakenly attacks your own healthy cells and creates inflammation in your body, according to the U.S. National Library of Medicine. Symptoms and treatments vary depending on the disease, but in most cases autoimmune disorder treatment includes medications that lower inflammation to help improve your symptoms and achieve remission. Biologics are one common autoimmune disorder treatment that can be used for a variety of diseases including rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and Crohn’s disease. If your doctor recommends taking a biologic medication or if you are interested in trying one, it’s a good idea to understand how the drug may help you. Here are seven things to know about taking biologics for autoimmune disorders.
1. Biologics are more targeted than traditional treatments.
Some medications treat autoimmune disorders by suppressing your entire immune system so your body doesn’t attack itself. Biologics target only the specific parts of the immune system that triggers the disease, which may help people experience fewer side effects.
“Rather than suppressing the whole immune system, we use biologics to target specific receptors or specific inflammatory pathways,” Zahi Touma, M.D., Ph.D., associate professor of medicine at the University of Toronto and clinician-scientist and staff rheumatologist with the University Health Network/Mount Sinai Hospital, tells SELF.
2. Biologics are usually prescribed after you’ve tried other medications.
Typically, physicians prescribe a biologic if other treatments haven’t helped your specific condition or if you experience too many side effects from those medications. For example, if you have an allergic reaction to your current medication, then your doctor may recommend a biologic.
Depending on your specific autoimmune disease and overall health, your doctor may suggest taking a biologic soon after your diagnosis. For instance, if your condition has progressed and you are in a lot of pain and discomfort, then your doctor may want to start with the most targeted treatment options. “The earlier you start treating aggressively, the more likely that outcomes are going to be better,” Anca D. Askanase, M.D., M.P.H, associate professor of medicine and director of Columbia University Lupus Center, tells SELF. (Common biologic medication options include adalimumab and infliximab, among others. Keep in mind that your treatment options may change over time based on new research and newly available therapies. Make sure you have ongoing conversations with your doctor about which treatment options may be best for you.)
Insurance companies may have specific requirements for covering biologics, like recommendations for trying other treatments first (which is another reason that your doctor may not prescribe a biologic when you’re first diagnosed). If you don’t have insurance or if your insurance company doesn’t cover biologics, some drug manufacturers offer patient assistance programs to help cover the cost of medications for people who can’t afford them. You can contact the manufacturer for the specific medication you’re interested in to learn details about any available programs.
3. Biologics aren’t available in pill form.
Taking a biologic is a little more involved than traditional pill medications. They are given through in-office intravenous (IV) infusions or at-home injections under the skin, at a frequency that can range from twice a week to once every three months. (The exact method will vary depending on the biologic.) In-office treatments can take up to a couple of hours to administer, so these may not be the best option for people with extremely busy schedules. (Individuals who are able to afford it can hire a home health care worker to help them administer their medication at home.)
At-home injectables may be a better option than infusions for people who travel often or have very unpredictable schedules. However, many biologics must stay cold in order to be safe and effective, according to the U.S. Food & Drug Administration. In this case, the drugs are typically stored in the fridge or surrounded by ice packs if you are traveling with them.
4. Biologics don’t provide immediate relief.
Unfortunately, the medication is not a quick fix. It may take some time before your symptoms get better because biologics need time to build up in your body and start working, Dr. Askanase explains. Depending on the biologic, it could take anywhere from several weeks to months to notice any changes. It’s a good idea to talk to your physician about how quickly you can expect a particular biologic to start working. Although your doctor won’t know how you will react to a particular medication, they may be able to give you an idea of how quickly a particular treatment has worked for other people or what symptoms generally get better first.
5. Biologics may come with side effects.
When discussing treatment, you might want to ask your doctor about potential side effects so you know what to expect. Here are some questions that can prompt a helpful conversation:
- What side effects do your patients typically experience with this biologic?
- What are some less common side effects you think I should be aware of?
- What should I do if I experience side effects?
- Should I be worried about side effects?
Some common side effects include pain and swelling around the injection site and possible infections, according to Johns Hopkins Arthritis Center.
If you have any side effects (or just general concerns about your medication), then you should always reach out to your doctor’s office, Dr. Askanase says. Or if you are experiencing something very severe, such as shortness of breath or tingling, then it’s a good idea to get emergency care as soon as you are able to.
All medications come with side effects, but Dr. Askanase says that your doctor can help you mitigate these so you can properly care for your condition and get some relief. “People should be reassured that the approval processes that we have in place for biologics are thorough to minimize risks and maximize efficacy and safety,” Dr. Askanase says. “Once the choice for a biologic is made between [a patient] and their physician, I think we need to embark on the process with full confidence and a lot of hope that this medication is going to allow for the best possible outcomes.”
6. You may need to try more than one biologic.
In some cases, the first biologic you take may not work for you, or it may suddenly stop being effective over time, explains Dr. Kaplan. If your symptoms don’t improve after a few months, then you may want to talk to your doctor about whether your medication is the best one for your situation. (Keeping a journal throughout your treatment that details all of your medications, habits, and symptoms can help you organize everything for your appointments.)
If you do experience relief after using one biologic but then your symptoms slowly become worse, or you develop new symptoms, it could be a sign your biologic has become less effective. First, you want to make sure you’re following the recommended treatment schedule for your particular medication because skipping doses can affect how well any medication works.
If you’re taking the medication as prescribed, then your immune system may have produced antibodies to your biologic and mistaken it for a possible invader. When that happens, your physician may recommend using another type of autoimmune disorder treatment or even another biologic. “There’s really a lot of hope out there for people with autoimmune diseases,” Dr. Kaplan says.
Related:
- 6 Signs Your Rheumatoid Arthritis Is Progressing
- 7 Questions People With Ulcerative Colitis May Have About Biologics
- What Exactly Are Biologics for Psoriasis?