Although conventional disease-modifying anti-rheumatic drugs (DMARDs) are often effective in controlling many musculoskeletal diseases, some rheumatic diseases, such as aggressive rheumatoid arthritis and psoriatic arthritis, merit additional approaches. Fortunately, great advances in medical research are providing a host of new treatment options for these diseases.
Some of these new medications are referred to as “biologics,” as they are manufactured using living cells as production factories. These biologics possess antibody-like molecules that target inflammatory mediators like tumor necrosis factor (Enbrel, Infliximab, Humira, Simponi Aria, and Cimzia) and inhibitors of inflammatory cytokines like IL1 (Anakinra), IL 6 (Actemra), and IL 17 (Stelara, Cosentyx, and Taltz).
There are also medications available that block immune system activation (Orencia), as well as monoclonal antibodies that selectively deplete specific populations of white blood cells involved in the disease process (Rituxan). Some medications act indirectly to limit antibody-forming B lymphocytes (Benlysta).
Finally, we often administer oral medications that can inhibit certain cell-signaling systems involved in rheumatoid arthritis (Xeljanz) and psoriatic arthritis (Otezla). Along with well-established risk profiles, medications in this category are generally very powerful and have the ability to exert control over most rheumatic diseases. Treatments are tailored to achieve an optimal risk-and-benefit profile for each individual patient.