What to Do When a Biologic Drug Stops Working

Biologic drugs have revolutionized chronic disease treatment and management, helping countless achieve remission and decrease the frequency and severity of their symptom flare-ups.

However, not everyone responds to medication as expected, leaving you wondering what to do when your biologic therapy stops working.

Watch the video: What to Do When a Biologic Drug Stops Working

Trial and Error

When your doctor prescribes a biologic, it’s not unusual to go through a trial and error period where your physician adjusts the dosing and frequency of your infusions until they find the right combination for you.

Because every patient experiences chronic diseases differently, it’s also possible that the first drug your doctor recommends may not improve your condition (primary non-response) or stops working (secondary loss of response). In either case, your biologic therapy needs revising.

Reasons Why Biologics Stop Working

There are two main mechanisms why your biologic may not provide the results you and your healthcare team expect:

Primary Non-Response 

This refers to patients who either don’t respond well to the drug and its attempt to address your inflammatory response or those who do not respond adequately to the initial dosage prescribed.

Secondary Loss of Response

This refers to patients who had a positive response to a biologic agent but later showed evidence of ongoing disease activity even with continued therapy. Secondary loss of response can happen because your current dose is no longer working for you or because your body has formed antibodies to the biologic.

Signs Your Biologic May Not Be Working

Determining whether your biologic is working for you is not always easy. First, you and your doctor need to define your treatment goals. For example, for some patients, treatment success means fewer and milder symptom flare-ups. For others, it could be achieving remission.

Additionally, biologics take time to work. Depending on the biologic medication, results may take a few months to notice. Your doctor can help you understand the timeline of your specific therapy.

Here are some warning signs that could signal your biologic isn’t working.

Your Symptoms Show No Improvement or Get Worse

It may take up to six months to see the full effects of a biologic. However, most patients notice some improvements before that. 

If you’ve been taking a biologic for at least three months and see no improvement or experience new or worsening symptoms, inform your doctor, as it might be time to modify your dose or switch to a different biologic.

You Continue to Experience Severe Disease Flare-Ups

If your flare-ups improve and later worsen, or if you continue to have frequent and severe symptoms, it’s time to check with your doctor and discuss if you need to change your therapy.

You Develop New Symptoms

Developing new symptoms can be a red flag that your current biologic is not working for you. For example, you should speak to your doctor if you experience changes in blood pressure, tingling, numbness, or allergic reactions. These can indicate that your body is not responding well to the biologic agent.

You Find Daily Activities Challenging

If you are having difficulty performing daily activities like dressing and eating, or if you experience unusual fatigue and brain fog, it could be a sign that your biologic therapy isn’t helping.

You Were Feeling Better and Now You Are Not

Some patients do great on a biologic for months and even years before they notice their symptoms returning.

If this is your case, this can be a sign that your current biologic is no longer working for you and needs to be changed.

What to Do When Your Biologic Stops Working

If you feel your biologic therapy isn’t working, you should first discuss this with your treating physician. They will probably order a series of tests to determine if you have adequate drug levels or have developed antibodies.

If your doctor doesn’t find antibodies interfering with your biologic, they can try modifying the dose. However, if you have antibodies that prevent your biologic from effectively targeting the source of inflammation, your physician will likely prescribe a different biologic.

 

Biologic therapy can help slow your disease progression and improve your quality of life if you work closely with your doctor and healthcare team to find the biologic that works best for you.

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