Biologics are a group of medications that suppress the immune system and reduce the inflammation in the joints. Even though suppressing the immune system can make it slightly harder to fight off infections, it also helps to stabilize an overactive immune system. By reducing the inflammation, the aim is to help prevent damage to the joints.
Best estimate of what happens to people with rheumatoid arthritis who take biologics:
ACR50 (number of tender or swollen joints and other doctor- or patient-assessed aspects of rheumatoid arthritis)*
- Among people who took abatacept, 47 people out of 100 experienced improvement in the signs of their rheumatoid arthritis compared to 21 people out of 100 who took a placebo (26% absolute improvement).
- Among people who took adalimumab, 63 people out of 100 experienced improvement in the signs of their rheumatoid arthritis compared to 21 people out of 100 who took a placebo (42% absolute improvement).
- Among people who took anakinra, 27 people out of 100 experienced improvement in the signs of their rheumatoid arthritis compared to 21 people out of 100 who took a placebo (6% absolute improvement).
- Among people who took etanercept, 61 people out of 100 experienced improvement in the signs of their rheumatoid arthritis compared to 21 people out of 100 who took a placebo (40% absolute improvement).
- Among people who took infliximab, 45 people out of 100 experienced improvement in the signs of their rheumatoid arthritis compared to 21 people out of 100 who took a placebo (24% improvement).
- Among people who took rituximab, 60 people out of 100 experienced improvement in the signs of their rheumatoid arthritis compared to 9 people out of 100 who took a placebo (51% improvement).
Side effects
- Among people who took adalimumab, eight people out of 100 dropped out of the study because of the side effects compared to five people out of 100 who took a placebo (3% absolute difference).
- Among people who took anakinra, nine people out of 100 dropped out of the study because of the side effects compared to five people out of 100 who took a placebo (4% absolute difference).
- Among people who took infliximab, 11 people out of 100 dropped out of the study because of the side effects compared to five people out of 100 who took a placebo (6% absolute difference).
- There may be little or no difference in people who dropped out because of side effects with abatacept, etanercept, and infliximab compared to people who took a placebo (fake pill).
*Editor’s note: The ACR50 was used to measure the efficacy of the DMARDs and was defined as 50% improvement in both tender and swollen joint counts and 50% improvement in three of the five following five variables: patient global assessment, physician global assessments, pain scores, Health Assessment Questionnaire score, and acute phase reactants (erythrocyte sedimentation rate or C-reactive protein).
