Many patients with rheumatoid arthritis rely on biologic drugs in the form of injections or infusions, but the newest drugs for rheumatoid arthritis (RA) involve no needles or IVs.

They are all oral therapies.

In this case, going back to basics with a good old-fashioned pill is not a sign of regression. It could actually be a sign of progress as doctors explore the next frontier in RA treatment.

Biologic drugs have been given to more than 600,000 RA patients worldwide since 1998. They are sometimes used alone and sometimes used in conjunction with other drugs.

A big concern for patients, aside from the hefty price tag and potential side effects, is the administration of these medications. They are often administered at home with a syringe or auto-injector pen, or in a hospital setting where patients receive the drug in a fashion that is much like chemotherapy.

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New Drugs Are Currently Being Tested

Many new oral drugs that are presently in trials, including many biosimilars, are being touted for RA patients because of the ease of use.

They’re also in a different drug class than the most commonly prescribed TNF inhibitors, etanercept (Enbrel), adalimumab (Humira), and infliximab (Remicade).

Oral versions of newer drugs such as JAK inhibitors are expected to become a regular line of defense for rheumatologists prescribing drugs to RA patients. Tofacitinib (Xeljanz) is one example, but others are in the pipeline.

Dr. Kelly Weselman, of WellStar Rheumatology in Atlanta, Georgia, agrees that having another option like oral JAK inhibitors could be beneficial to patients.

“The development of a new class of oral agents for treatment of RA called JAK inhibitors provides several benefits,” she said. “This represents a class of medications targeting a different part of the immune pathway compared with other medications available.”

“Certainly for many patients,” Weselman added, “it is an advantage to have another medicine available in oral form as many patients are reluctant to use injectable medications or receive an infusion.”

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Lucila Roca, an analyst and author of the study Product and Pipeline Analysis of the Global Rheumatoid Arthritis Therapeutics Market, said in a statement to the press that, “The market is expected to see a flood of several oral therapies with equal or better efficacy and safety than biologics.”

She also noted, “Biosimilars expect to be a viable alternative for patients who are unable to purchase biologics. They will also be the preferred choice for governments and private insurance companies looking to limit expenditure.”

Moving forward, patients as well as pharmaceutical market analysts can expect oral biosimilars to have more of a presence on the RA medication scene as some of these drugs transition out of trials and into the marketplace.

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