Biologic Response Modifiers

These medications have been developed to specifically target components of the immune system that appear to be involved in inflammation in the setting of various rheumatic diseases, particularly rheumatoid arthritis. While biologic response modifiers suppress the immune system more selectively than many of the above agents, patients are generally rendered more prone to developing infections while taking these medications. Because of the expense involved in manufacturing these drugs, the cost of biologic response modifiers is considerable but typically covered by most insurance plans under certain situations. For those without coverage needing these medications, programs are available through participating pharmaceutical companies to provide them for patients.

Presently available biologic response modifiers are administered only in injectable or intravenous forms and include the tumor necrosis factor (TNF) antagonists etanercept, infliximab, and adalimumab, and the interleukin-1 antagonist anakinra. Recently, two new intravenous medications with different mechanisms of action, rituximab and abatacept, have been approved for the treatment of rheumatoid arthritis and may also be used in other rheumatic diseases in the near future.