World Arthritis Day 2018: Jaipur doctor Rahul Jain on ‘Biological Medicines’ for RA treatment

Jaipur: Many awareness programs are being organized in Jaipur on the occasion of World Arthritis Day 2018. Prominent doctors in Jaipur say many new innovations have made the treatment easier and convenient for arthritis patients. The PinkCity Post spoke to Dr Rahul Jain, Consultant Rheumatologist, Narayana Hospital in Jaipur. Dr Jain discussed the scope of ‘Biological Medicines’ in the treatment of Rheumatoid Arthritis (RA). Dr Jain says the meaning of arthritis is inflammation of joints. Rheumatoid Arthritis is the common form of arthritis which involves the symptoms of pain and inflammation of joints. It is thought to be an autoimmune disease.The immune system normally produces antibodies which protect us from attack of viruses, bacteria and other germs. In patient with RA, antibodies are formed against the tissue of the body, more specifically, tissues around joints or synovium which cause inflammation and pain and further damage to the joints if not treated early.Commonly affected joints are the small joints of the fingers, thumbs, wrists, feet and ankles. Biological Medicines: What does it mean? These are newer type of medicines used to relief the symptoms of rheumatoid arthritis (RA) and decrease the harmful effect of the disease on the bone joints.These are usually prescribed when older medicines called disease-modifying antirheumatic drugs (DMARDs) have not worked so well. These are made by living organism and different from other drugs made by chemical processes. Examples include adalimumab, etanercept, golimumab, infliximab, certolizumabpegol, anakinra, abatacept, rituximab and tocilizumab. These medicines can also be used to treat other conditions like different form of arthritis, and chronic-inflammatory skin disorder or bowel disease. How do Biologicals Work? Biological medicines work by blocking chemicals in the body which may cause inflammation.For example, some biologicals block tumour necrosis factor alpha (TNF-alpha) responsible for inflammation. These are adalimumab, etanercept, golimumab, certolizumabpegol and infliximab. Some other types of medicines block interleukin and reduce inflammation.Biological medicines are usually prescribed when your RA has not improved by using DMARDs. These are only prescribed by specialized doctors (Rheumatologist) under strict supervision.These medicines can be taken by either injection or by a drip into a vein in the arm. How Quickly and How Long? Biological medicines work better than DMARDs and protects joints for long time.It is possible that everyone will not respond to each biological medicines but if it is going to work, you may feel better within 12 weeks.They are normally prescribed for six months but it may continue till the desired effect of the medicine for a long time.Once the symptoms of RA are under control, your doctor may reduce the dose and eventually stop your biological medicine.The decision is depending upon the symptoms of your disease and what the doctor feels is best for you.   Do’s and Don’ts with Biological Medicines

• Screening of different types of infectionscan be recommended before starting TNFαinhibitor and other biologics.
• You are not recommended to take biological medicine if you are pregnant or breastfeeding lady, having any infection or TB.
• You are advised to avoid live vaccine (including shingles vaccine). Annual flu vaccine and regular pneumonia vaccine is recommended as these are not live vaccine.
• Please ensure you have done blood test as per recommendation by your doctor.
• Always consult with your doctor on time as per schedule.
• Do not take your biological medicine if you have infection or develop any symptom of infection (e.g. fever, productive cough, feeling unwell) and reach to your doctor immediately.
• Do not take your antibiotic with biological medicine, it may slow down the immune system to fight against infection.

Disciplined medication is the key foundation to success for a patient. With the help of newly biological medications we can provide a better and normal living to the patients with rheumatological disorders.