Biological response modifiers (BRMs)
Substances that stimulate the body's response to infection and disease. The body
naturally produces small amounts of these substances. Scientists can produce some of them
in the laboratory in large amounts for use in treating cancer, rheumatoid arthritis, and
other diseases.
BMRs used in biological therapy include monoclonal antibodies, interferon,
interleukin-2 (IL-2), and several types of colony- stimulating factors (CSF, GM-CSF,
G-CSF). Interleukin-2 and interferon are BRMs being tested for the treatment of advanced
malignant melanoma. Interferon is a BRM now in use to treat hepatitis C.
Side effects of Biological response modifiers
One of the advantages of biologic agents is they act very
specifically to neutralize targeted immune-system components and, unlike DMARDs, are not
processed by the organs of the body. This means there are relatively few side effects. As
these are new drugs, however, any long-term side effects are not yet known
As BRMs are administered by injection or infusion, the most
common general side effect is a mild skin reaction at the site of the injection. Typically
this amounts to itchiness, redness and minor swelling. Some patients may experience
headaches during intravenous infusion, and there may be an increased susceptibility to
infection
There are some important health cautions to consider before
beginning treatment with a biologic agent. BRMs are designed to suppress certain immune
system functions. The immune system is a key part of your body’s defence against
infections. This means use of these biologic agents can present a serious risk to patients
who are prone to infection (e.g. diabetics) or who have an active infection. Before
beginning treatment with any BRM, your doctor should screen you for any infections,
including tuberculosis to which you may have been exposed some time in the past.. Also, if
you develop an infection while under treatment with a BRM, stop your injections and check
in with your doctor. If the infection requires antibiotic therapy you may be asked to
postpone your injections until the antibiotics are finished and the infection has cleared.
Other side effects related to biologic agents are specific
to the type of BRM used and are explained in the sections dedicated to each drug. |