Most of the medication in your cabinet is likely made from nonbiological materials. Think for a moment about common drugs such as antacids, aspirin, or statins prescribed by your doctor. These are all created in a laboratory from synthetic ingredients. Since these medications are so familiar, many people may not realize they don’t come from nature.
Biologics are different. They are a distinct class of drugs made from biological sources. More specifically, they’re extracted or synthesized from biologic systems, but they often mimic cell products that occur naturally in the body. These treatments hold promise of relief for people living with inflammatory conditions such as arthritis. Many biologics are only now becoming widely prescribed, but the class of treatment has existed for many decades.
Synthetic drugs have a specific makeup. Aspirin, for example, is made up of 21 atoms formed in a specific shape. By contrast, the full composition of biologics is often unknown. That’s because the material is complicated and larger than chemicals made in a laboratory. These drugs are fragile and kept in liquid form, and they’re injected or administered intravenously.
Many medical products you’re likely aware of are similar to biologics. Vaccines and blood used for transfusions are two examples.
Biologics have had significant influence in the medical field. In 2017, the FDA approved biologics to treat a number of conditions, including kidney disease, multiple sclerosis, asthma, high cholesterol, rheumatoid arthritis, lupus, and Crohn’s disease, according to a report in Scientific American.
Scientists have made some major advances in treatments, thanks to biologics. T-VEC, a drug that targets melanoma cells, is classified as a biologic. The drug is made from a genetically modified herpes virus. It kills the cancer cells while leaving the healthy cells intact.
Many well-known medications, such as Enbrel and Humira for psoriatic arthritis, are biologics. These drugs target the areas of the body’s immune system that are causing the symptoms. For example, people living with psoriatic arthritis have too much tumor necrosis factor-alpha (TNF-alpha) protein. This protein causes inflammation. Enbrel deactivates TNF-alpha, reducing the inflammation.
The appeal of biologics is their ability to target a specific part of the body for treatment, as in the case of Enbrel. Conventional drugs work on either the body’s entire immune system or on a broader range of immune pathways.
Drugs, both synthetic and biologic, typically work by entering cells within the body. Once inside, the drugs change how the cells operate, work, or interact with immune cells. Synthetic drugs are smaller than biologics, so they don’t always hit their target. Biologics are larger, which gives the drugs more ways to attach in the right spot.
Even though biologics hit their target marker with greater precision, they don’t always work the same in everyone who takes them. Doctors still don’t know which biologic will work for each specific patient. For example, one psoriatic arthritis patient may respond well to Enbrel because it targets TNF-alpha. Another patient may respond to a different biologic, such as Cosentyx, which targets the protein interleukin-17.
As with conventional medications, biologics have other possible side effects and risks. It all depends on how the drug works in the body. Johns Hopkins Arthritis Center warns that some biologics change how the immune system functions. For people who use certain types of biologics, there’s a greater risk of infection and cancer. Additionally, biologics can potentially trigger other autoimmune conditions.
Biologics are not a first-line treatment for most conditions. Depending on your medical history, your doctor may want to start with conventional drugs before biologics. For example, if you’re diagnosed with psoriatic arthritis, most doctors may first prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) or disease-modifying antirheumatic drugs (DMARDs). If those drugs don’t work, your doctor may decide that a biologic is a better treatment option.
Recent scientific advancements have removed some of the mystery surrounding biologics. As new drug approvals demonstrate, there is a growing focus among researchers on biologics. These drugs have the potential to treat a wide range of conditions. They represent a new generation of medications that offer the chance for improved well-being in many people.