Difference Between DMARDs and Biologics

The key difference between DMARDs and biologics is that DMARDs (Disease-Modifying Anti-Rheumatic Drugs) are conventional drugs that can help to prevent joint damage and deformity from Rheumatoid Arthritis (RA) while biologics are genetically engineered drugs developed as a medication for RA.

Rheumatoid Arthritis (RA) is an autoimmune disease which affects joints. It is a long term disease which results in warm, swollen and painful joints. This disease occurs when the immune system mistakenly attacks cells that line the joints. Treatments for RA can stop the pain and swelling. DMARDs, biologics and Jak inhibitors are three types of drugs used to treat and control moderate to severe RA in adults. DMARDs are traditional drugs that target the entire immune system. Biologics, on the other hand, are genetically engineered drugs that target specific steps in the inflammatory process. Biologics are expensive and have potential risks associated with them.

CONTENTS

1. Overview and Key Difference
2. What are DMARDs
3. What are Biologics
4. Similarities Between DMARDs and Biologics
5. Side by Side Comparison – DMARDs vs Biologics in Tabular Form
6. Summary

What are DMARDs?

Disease-Modifying Anti-Rheumatic Drugs (DMARDs) are conventional or traditional drugs that prevent joint damage and deformity from RA. Methotrexate is the first DMARDs which is the most common type. Hydroxychloroquine, mycophenolate, ciclosporin, cyclophosphamide and sulfasalazine are several types of DMARDs. These traditional DMARDs usually come as pills. DMARDs target the entire immune system, unlike biologics.

Different DMARDs cause different side effects. Methotrexate may cause liver damage, bone marrow suppression and miscarriage of birth defects. Conventional DMARDs are slow acting. They take months to respond. However, in comparison to biologics, DMARDs are cost-effective.

What are Biologics?

Biologics are genetically engineered drugs for RA. They work in a more targeted way in blocking cytokines. They target specific steps in the inflammatory process. Most biologics have a much faster action than conventional DMARDs. Biologics are given to RA patients after trying other treatments first, and when they do not respond. Furthermore, biologics are given in combination with a conventional DMARD such as methotrexate. Biologics are more expensive and show a higher risk as well.

Biologics are injected under the skin. They can also be given by intravenous infusion. Skin reaction is the most common side effect that biologics show. Skin cancer is a serious side effect that biologics can cause. Abatacept, rituximab and tocilizumab are several biologics.

What are the Similarities Difference Between DMARDs and Biologics?

• DMARDs and biologics are two treatment options for RA.
• Both types of drugs can increase the risk of infections.
• DMARDs can be paired with biologics and use.
• Both cause side effects.
• Moreover, both have potential risks.

What is the Difference Between DMARDs and Biologics?

DMARDs are traditional drugs used to treat Rheumatoid Arthritis while biologics are genetically engineered drugs developed to treat Rheumatoid Arthritis. So, this is the key difference between DMARDs and biologics. Furthermore, the DMARDs target the entire immune system while biologics target specific steps in the inflammatory process. Thus, this is also a major difference between DMARDs and biologics.

Moreover, biologics are at higher risk and higher prices in comparison to DMARDs. Also, another difference between DMARDs and biologics is the delivery method. DMARDs are available as pills while biologics are injections.

Summary – DMARDs vs Biologics

DMARDs and biologics are two types of drugs used to treat rheumatoid arthritis. DMARDs are classical or conventional drugs and are safe for use. They come as pills. Biologics, on the other hand, are genetically engineered drugs which are more effective and more expensive. They act faster than DMARDs. Also, biologics are much more targeted than DMARDs. DMARDs, unlike biologics, target the entire immune system. Besides, biologics are injections. Thus, this summarizes the difference between DMARDs and biologics.

Reference:

1. Nurmohamed, Michael T, and Ben A C Dijkmans. “Are Biologics More Effective than Classical Disease-Modifying Antirheumatic Drugs?” Arthritis Research & Therapy, BioMed Central, 2008, Available here.
2. Benjamin, Onecia. “Disease Modifying Anti-Rheumatic Drugs (DMARD).” StatPearls [Internet]., U.S. National Library of Medicine, 4 July 2020, Available here.

Image Courtesy:

1. “Methotrexate ball-and-stick model” By Vaccinationist – PubChem (CC BY-SA 4.0) via Commons Wikimedia
2. “Rituximab ( MabTas )” By Ib intaspharma – Own work (CC BY-SA 3.0) via Commons Wikimedia