Biologic Drugs for Lupus

Reviewed by: HU Medical Review Board | Last reviewed: June 2022

Biologics are drugs made from material from living things. The most common types of biologic drugs are called monoclonal antibodies. Monoclonal antibodies are proteins designed to bind (chemically attach) to a certain protein in our cells. This can change how our immune system works.1

Two biologic drugs are approved to treat people with lupus. They work in different ways to reduce immune system activity and inflammation.

What are biologic drugs?

Biologic drugs are usually created using bacterial or yeast cells grown in a lab. They may also be created by taking cells from humans or other animals.2

Most biologic drugs are antibodies. Antibodies are proteins made by our immune system. They bind invaders like viruses and bacteria. This sends signals to immune cells to attack the invaders. Antibodies can be made in a lab to bind to specific proteins in our body. These are the monoclonal antibodies.1

Examples of lupus biologics

Two biologic drugs are approved by the US Food and Drug Administration (FDA) to treat lupus:3,4

Other biologics are FDA-approved to treat conditions other than lupus. But they can be used off-label to treat lupus. This includes rituximab (Rituxan®).5

There are studies looking at the use of biologics approved for other conditions to treat people with lupus. These include:2,6

  • Ravulizumab-cwvz (Ultomiris®)
  • Secukinumab (Cosentyx®)
  • Guselkumab (Tremfya®)
  • Daratumumab (Darzalex®)
  • OMS721 or narsoplimab

New biologics are also being studied specifically for lupus.2,6

How do biologic drugs work to treat lupus?

Monoclonal antibodies are the biologics that treat lupus. They work in different ways to reduce the activity of your immune system. This helps reduce inflammation and symptoms of lupus.2

Belimumab (Benlysta) and rituximab (Rituxan) work by reducing the survival of B cells. These are white blood cells that fight germs. In lupus, B cells mistakenly fight healthy cells. Belimumab binds a protein called B lymphocyte stimulator. Rituximab binds a protein on the surface of B cells called CD20. Both treatments cause B cells to die.2,4

Anifrolumab-fnia (Saphnelo) works by reducing activity in your immune system. It binds a protein called the type 1 interferon-alpha receptor. This blocks the activity of chemicals that increase inflammation called type 1 interferons (IFNs).2,3

Many other biologic drugs are being tested to treat lupus. These drugs work in different ways to treat lupus, such as by:2

  • Reducing B cell growth
  • Reducing the activity of other white blood cells
  • Blocking IFN activity
  • Blocking other chemicals that increase inflammation

Biologics side effects

Side effects can vary depending on the specific drug you are taking. Common side effects of biologic drugs used in lupus include:3,4

  • Nausea and diarrhea
  • Fever, stuffy nose, and sore throat
  • Trouble sleeping
  • Depression
  • Headache
  • Reactions at the place on your body where you inject the drug
  • Coughing

Biologic drugs can also cause more serious side effects. These include:3,4

These are not all the possible side effects of biologic drugs. Talk to your doctor about what to expect when taking biologics. You also should call your doctor if you have any changes that concern you when taking biologics.

Other things to know about biologics

Take biologic drugs exactly as your doctor prescribes. Before taking them, tell your doctor your full medical history. Other medical conditions or drugs you take can increase the risk of side effects. Tell your doctor about:3,4

  • Current or recurring infections
  • Mental health problems
  • Recent or upcoming vaccinations
  • Allergies to other medicines
  • Pregnancy or planned pregnancy
  • History with cancer
  • Other drugs you take, including:
    1. Over-the-counter drugs
    2. Vitamins
    3. Supplements

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