This last post about rheumatoid arthritis (RA) medications focuses on Biologics. Previously, I've coveredNSAIDs, which treat symptoms of inflammation and pain, and non-biologicDMARDs, medications that treat the RA itself.
RA is a systemic illness, which affects not just your joints, but also other systems in your body, including the vascular systems and internal organs, such as the heart. At this time, there is no cure for RA. It is, however, possible to suppress the disease, slowing down or even stopping it from progressing and damaging the systems in your body.
什么是生物制剂？
生物制剂是一类设计用来治疗类风湿性关节炎的药物。他们遗传工程从活细胞制造的蛋白质。它们靶向参与炎症反应的特定的物质，如细胞（B细胞淋巴细胞或T-呼叫）和蛋白质（肿瘤坏死因子α，白介素6）。用于治疗RA的生物制剂还可以用于治疗其它自身免疫性疾病，如银屑病关节炎，多发性硬化和克罗恩。
Biologics were first introduced in 1999 when Enbrel came on the market. It was quickly followed by several others, such as Humira, Remicade, Cimzia, Simponi, andseveral others。At present, there are about a dozen on the market and many more in development. Most Biologics are administered by injection or IV infusion.
什么是有针对性的，合成的DMARDs？
Similar to biologics, a new class of medications called targeted synthetic DMARDS (tsDMARDs) are used to treat Rheumatoid Arthritis. Xeljanz is the only targeted synthetic DMARD currently available in the United States is a pill taken once or twice a day. Targeted synthetic DMARDs are similar to Biologics in efficacy.
为什么采取生物制剂或靶向合成的DMARDs？
生物制剂和靶向合成的DMARDs是在RA治疗的一场革命。他们已经引起了变化，不仅在RA的控制率，而且在如何治疗。生物和有针对性的合成的DMARDs在治疗RA非常有效，导致人显著量与RA实现remission or low disease activity。
因为现在能够抑制疾病本身的态度来对待已经改变。从过去的“去低，走慢”，这通常是无法控制病情，造成关节和其他系统损害，治疗是目前早期积极，继“treat to target“办法。
Treating to target involves adjusting medication every three months or so until remission has been achieved. Rates of remission vary depending on the measurement used. The newACR/EULAR criteria十分严格，导致只有6％的缓解率。你恐慌之前，要知道，这些标准用于临床试验的评价。在临床实践中使用的测量更加灵活，最好的缓解率目前实现的是40％-50％。有更多的人，低疾病活动也是可能的。
生物制品也导致了RA的另一区域显著变化。由于全身炎症反应，患有RA有higher risk of heart attack and stroke。在过去，这导致了死亡率差距：具有10往年低预期寿命高于普通人群。自从引入生物制品，有研究表明，mortality gap has been reduced作为下级疾病活动积极影响心脏健康。这强调治疗RA的积极保护，不仅关节，也是身体的其余部分的重要性。
除了使在RA医学方面一个令人难以置信的变化，生物制品也造成生活质量的革命经历的人与RA。更多的人比以往任何时候都生活基本正常生活，继续参加他们的家庭，工作和社区。
不幸的是，生物制品是非常昂贵的，这会影响你的使用它们的能力。不过，也有一些服药财政援助方案它可以帮助你获得你需要的药物。
常见的副作用，以及如何对其进行管理
Biologics and targeted-synthetic DMARDs are immunosuppressants, which means that they will make you more vulnerable to infection. It is quite likely that if you're taking a biologic medications, you will be more susceptible to catching contagious illnesses and they may hit you harder. For most people, the感染的风险可以被管理通过被加倍小心，以避免疾病的传染阶段的人只要有可能，以及采取额外的照顾，以避免污染在家庭和公共。获取流感，肺炎和破伤风疫苗还可以帮助保护你。
一个被人们所经历的最常见的感染采取生物制剂是上呼吸道感染或鼻窦感染。您可以managing this riskby using a saline solution or a Neti pot to rinse out the sinuses and reduce the risk of infection.
生物制剂和targeted-synthetic DMARDs是一个serious medication for a serious problem. This means that they do come with the potential for more serious side effects than some other medications. Do take an illness or infection seriously and talk to your doctor about signs that you should be seeking urgent medical help. It is important to remember that these types of side effects are rare, so there's no need to be anxious.
什么一直是你的经验服用生物制剂为您RA？