There is not one answer to this question. Biologic therapies are large protein based structures which mimic proteins in the human body. They are created by engineering living cells to create these proteins in a bioreactor. The cells used can be bacterial, such as in E. Coli which produces Insulin, to Chinese Hamster ovary cells commonly used in many of the biologics which reduce inflammation in autoimmune diseases like rheumatoid arthritis. There are biologic therapies used to treat many medical conditions and the list is growing; cancer therapies, diabetes, elevated cholesterol, asthma, urticaria, osteoporosis, Crohn’s disease, ulcerative colitis, psoriasis, rheumatoid arthritis and many more.
We do not give two biologic therapies together which have the same action in the body as their adverse effects will be compounded. However, we can use biologic therapies in combination that do not have the same activity in the body and are used for different conditions where there adverse effects are not overlapping. For instance, the biologic denosumab (Prolia) for osteoporosis is commonly used in patients with rheumatic inflammatory conditions who are also taking biologics such as adalimumab (Humira) or infliximab (Remicade, Inflectra, Renflexis).
In the years ahead as the number of biologic therapies increases, it may not be unusual to see people on multiple biologic therapies to manage their many medical conditions.
Carolyn Whiskin is the Pharmacy Manager for Charlton Health. Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.