Biolgoical Agents in Autoimmune Rheumatic Diseases

Abstract

Since the late 1990s, the major biologic approaches in clinical use include agents that: ▪ Interfere with cytokine function. ▪ Inhibit the “second signal” required for T-cell activation. ▪ Deplete B cells (Felson et al., 1995). Biologics are genetically engineered proteins derived from human genes. They work to decrease pain and inflammation, to reduce tissue damage, prevent joint damage and to preserve the structure and function of the joints disability, enhance quality of life (QOL) and employment. They differ significantly from traditional drugs in that they target specific components of the immune system instead of broadly affecting many areas of the immune system(Nandi et al., 2008). Other medicines, such as pain relievers, NSAIDs, prednisone and synthetic DMARDs are given to provide faster relief of ongoing symptoms and to help prevent long-term disability (Smolen et al., 2014). The specific use of biologics in each disease was detailed in the review. To sum uptaking into account the evidence for effectiveness and safety and after failure of csDMARDs, these are:  Rheumatoid arthritis:The anti-T cell agent abatacept (Orencia®) and theanti TNF-α adalimumab (Humira®) and etanercept (Enbrel®) had shown greater effects (Weinblatt et al., 2007).  Sjӧgren syndrome:anti-B cell biologic agents, rituximab (Mabthera®), epratuzumab (LymphoCide®) and belimumab (Benlysta®) have been shown promising results (Bowman, 2012).  Systemic lupus erythromatosus:The anti-B-lymphocyte stimulator (anti-Blys) antibody belimumab (Benslysta®) demonstrated the bestefficacy and safety(Stohl and Hilbert, 2012).  Systemic sclerosis:Anti–TNF-α agents appear to improve inflammatory arthritis and disability in patients with SSc (Xuan et al., 2014).  Polymyositis and dermatomyositis: A reduction of elevated CPK levels was observed more often after anti-B cell agent rituximab (Mabthera®) and anti-T cell agentabatacept (Orencia®) therapy (Shinjo et al., 2013).  Ankylosing spondylitis:TNF-α blockade treatment for AS has huge and undeniable value such asadalimumab (Humira®), etanercept (Enbrel®), golimumab (Simponi®) and infliximab (Remicade®) (Gensler et al., 2012).