You may find that you’ve been on a biologic for years and suddenly start experiencing flare-ups again. This is referred to as a secondary loss of response. In another scenario, you might have recently started your first biologic and haven’t noticed much improvement even after several months. This is referred to as a primary loss of response. In both situations, it is important to know that there are several advanced treatment options, and there’s no need to feel discouraged! This is actually a normal and expected part of managing immune-mediated conditions on your treatment journey
Immune-mediated conditions such as psoriasis, rheumatoid arthritis, or Crohn’s disease and ulcerative colitis are complex and can change over time. A treatment that worked well at first may become less effective as your body and immune system evolve. Biologic medications work by targeting specific parts of the immune system, depending on the condition, to reduce inflammation. Over time, your body can adapt in a few ways. Sometimes the immune system “learns” to work around the medication, or it may produce antibodies against the medication that reduce how well the drug works. Other times, the underlying drivers of your condition may shift, meaning a different biologic that targets another pathway may be a better fit. In some cases, specialists can order tests to determine whether antibodies have formed against the medication, which can help guide the next treatment choice. Sometimes, instead of switching right away, dose optimization (such as increasing the dose or frequency) may also improve response before moving to another option.
The goal is always to keep your condition well-controlled with the safest and most effective option for you. Your specialist, along with our team at Charlton Health, is always here to guide you through your options and ensure you feel informed and comfortable every step of the way.
Joyce Ayad is a pharmacist at Charlton Health who believes in providing patient-focused care, supported by her previous experience working with specialty drugs, the pharmaceutical industry, and more.