check that you have ongoing conversations with your doctor about which treatment options may be best for you.
How do autoimmune diseases work?
To understand autoimmune diseases, its important to knowhow your immune system normally works.
Learning how biologics work can help you understand your treatment.
We all have B cells3that patrol our bodies looking for foreign invaders like harmful bacteria and viruses.
To assist with this, our B cells produce proteins called antibodies that help identify those invaders.
This process causes bodily inflammation, which manifests in symptoms likejoint pain, rashes, and fatigue.
What is a biologic, anyway?
Basically,biologic drugs workin a much more targeted and precise way.
They block the specific parts of your immune system that are behind your autoimmune disease and its symptoms.
Dr. Husni likens using biologics against mild forms of autoimmune disease to using a grenade against a mosquito.
If you have one mosquito, you probably just use a flyswatter, she says.
What happens inside my body when I take a biologic?
There are numerous cytokines that can trigger inflammation and cause symptoms in each autoimmune disease.
In rheumatoid arthritis, TNF plays a really big role [in triggering inflammation], Dr. Husni says.
Inpsoriatic arthritis, IL-17 and IL-23 play a bigger role.
Before cytokines can produce inflammation, they need to attach to receptors on the surface of your cells.
Think of it as opening the lock on your front door with a key.
You cant turn on the lights until you unlock and kick off the door.
Cytokines cant affect your cells until they initiate the lock.
Biologics prevent cytokines from unlocking your cells and causing inflammation and possible damage in a few ways.
Some of these medications block11the receptors on cells so that cytokines cant attach to them.
Other drugs fill the receptor themselves, leaving no room for the cytokine.
Each biologic works against a specific cytokine.
But some autoimmune diseases are fueled by more than one cytokine.
So how does your doctor know which one to choose?
Your insurance coverage, if you have it, can also factor into the decision, Dr. Husni says.
What types of biologics are there?
Biologics are divided up into groups, or classes, based on the inflammatory pathway they target7.
Each works by preventing a particular cytokine from causing inflammation.
Biologics are very sensitive to the acid in your stomach and cant be taken orally like many conventional medications.
For example, some medications can be self-administered through an injection under your skin weekly.
Other drugs are given through an intravenous infusion monthly or every few months.
What about side effects?
Any drug you take can cause side effects, and biologics are no exception.
Were not wiping out [the immune system], but were lowering it.
When you suppress it, it’s possible for you to get more infections, Dr. Husni says.
If that happens, you may need to try a new medication.
Biologics are complex drugs, and they can take some time to figure out.
Getting familiar with how they work to reduce your symptoms can make you more comfortable with your treatment plan.
