Superheroes in autoimmune warfare: Biologic therapies in current SA practice

Tarr, G; Hodkinson, B; Reuter, H

Superheroes in autoimmune warfare: Biologic therapies in current SA practice

Journal Article

2014

Journal Title

South African Medical Journal

Link to Journal

https://dx.doi.org/10.7196/SAMJ.8947

Department

Department of Medicine

Faculty

Faculty of Health Sciences

Abstract

Biologic drugs targeting immune cells or cytokines underlying systemic inflammation have dramatically improved outcomes in patients with rheumatological and autoimmune diseases. Nine biologic drugs are currently available in South Africa (SA) - all showing good efficacy and safety profiles. Their high cost and potential adverse events preclude them from being used as first-line agents. They are therefore indicated for severe disease refractory to standard therapies, and their use must be initiated by a specialist. The most important adverse effect of this class of drugs is infection and, in SA, tuberculosis is of particular concern. As new targets in the immune system are identified, new biologics will be developed. The current challenges are to optimise standard care for all patients with autoimmune diseases, and to offer the appropriate biologic to patients with refractory disease.