title: Superheroes in autoimmune warfare: biologic therapies in current South African practice.
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.
authors.forename: G
authors.initials: G
authors.lastname: Tarr
authors.forename: B
authors.initials: B
authors.lastname: Hodkinson
authors.forename: H
authors.initials: H
authors.lastname: Reuter
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001327:Autoimmune Diseases / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D019947:Receptors, Interleukin-6 / Q000037:antagonists & inhibitors; D013019:South Africa; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; C508603:IL6R protein, human; D007166:Immunosuppressive Agents; D019947:Receptors, Interleukin-6; D014409:Tumor Necrosis Factor-alpha