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REVIEW ARTICLE
Year : 2019  |  Volume : 7  |  Issue : 4  |  Page : 103-108

Biologics: A tectonic shift in the management of rheumatoid arthritis


1 Department of Rheumatology and Immunology, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
2 Department of Rheumatology, Apollo BGS Hospital, Mysore, Karnataka, India

Correspondence Address:
Dr. Shiva Prasad
Apollo BGS Hospital, Mysore, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/AJIM.AJIM_30_19

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Rheumatoid arthritis (RA) is a chronic inflammatory disease of the joints which if ongoing, has a significant bearing in the quality of life and has a variety of systemic manifestation which reduces the overall life span due to an ongoing inflammatory process. There has been a shift in the management of RA right from the early identification of the disease to targeting the pathogenic mechanisms. The changing modalities with emphasis on remission and low disease activity in early RA should be the primary goal. Disease control of RA with the use of combination synthetic disease modifying anti-rheumatic drugs or in combination with biological agents have improved disease-related outcomes. This prevents the progression of disease, morbidity, and has a significant bearing on the overall economic productivity of the patient and the society. Costs of the biological drugs is a major hurdle in their usage. Introduction of biosimilars have lead to a decrease in the cost of the biological molecules and hence their use becoming more widespread. The purpose of this review is to highlight the changing treatment modalities with the advent of biological disease modifiers in RA and a rationale for their use. The strategy in the treatment of RA should be goal directed rather than just relief of symptoms.


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