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Obesity Research
Obesity Research
iConcept Press

Chapter 4

Obesity Research

Use of Biologics for Management of Rheumatoid Arthritis

by Canna Ghia, Jignesh Ved and Gautam Rambhad

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Improvements in the understanding of disease pathogenesis, coupled with advances in biotechnology, have opened up promising avenues in the management of diseases. A prominent example is the paradigm shift in the management of rheumatoid arthritis, brought about by the biological agents. The clinical significance of biological agents is underlined by excellent control of inflammatory activity, along with retardation of disease progression. These agents target cellular or humoral immunological pathways at various molecular levels, including blockade of TNF-α, IL-6, CD-20, etc. Advances in clinical development, manufacturing technologies, and formulation developments, have greatly benefitted the safety and efficacy profile of biological agents. Various clinical practice guidelines establish the principles of using biological agents in rheumatoid arthritis. These agents are generally preferred for use, following inadequacies of the initial therapy with synthetic disease modifying anti-rheumatic drugs (s-DMARDs). The role of biological agents as first line therapy remains controversial, although they may be effectively used in combination with s-DMARDs. In case of intolerance, monotherapy with biological agents may be considered. Switching therapies, from one biological agent to another, may be considered in cases of diminishing efficacy or safety concerns. Switching between different classes may also be considered, in presence of inadequacies in response. Whereas certain safety-concerns, like increased risk of infections, may be universally observed across all the classes of biological agents, others may be specific to the respective agents. Development of similar biologics (biosimilars) has generated much interest, although it remains a challenging area for the researchers as well as regulatory authorities.

Author Details

Canna Ghia
Medical and Research Department, Pfizer Limited, India
Jignesh Ved
Medical and Research Department, Pfizer Limited, India
Gautam Rambhad
Medical and Research Department, Pfizer Limited, India


Canna Ghia, Jignesh Ved and Gautam Rambhad. Use of Biologics for Management of Rheumatoid Arthritis. In Obesity Research. ISBN:978-1-922227-67-6. iConcept Press. 2016.