'Biosimilars can be a boon for autoimmune, cancer patients'

Biological drugs — or biologics made from bacteria or living cells — are a boon for many kinds of autoimmune diseases and even cancer. But very few people in India have a clear idea about them. Umesh Isalkar speaks to Dr Syamasis Bandyopadhyay, senior consultant rheumatologist at Kolkata’s Apollo Multispecialty Hospital, to know the basics.

How do biological drugs work to cure disease?

They target specific components responsible for overactive immune response seen in autoimmune diseases to stop disease progression without suppressing the immune system as a whole. As with many chronic illnesses, biologics are usually a long-term treatment. But the dosage and duration may vary depending on the patient’s response. These drugs are licensed by competent authorities worldwide, just like conventional medicines, with hundreds of studies supporting their effectiveness.

Can biologics be used for all kinds of diseases?
No. Biologics have specific scientific criteria for each medical condition. Often, these drugs are used along with conventional treatments to achieve better results.

Why don’t Indian patients have a fair idea about them?
That’s because biologics are underutilized in India compared to the developed world as they are more expensive. Only specialist doctors are authorized to prescribe them, following established guidelines and indications. The higher cost is largely due to the drug’s complex development process and manufacturing. But India has started producing biosimilars — affordable versions of biological drugs — over the past seven years. Biosimilars are about one-third the cost, making treatment more accessible. Biosimilars have also led to a reduction in the prices of biologics. However, typically, alternatives are tried first before biologics are considered.

What are JAK inhibitors and what do they treat?
They are a newer class of drugs used to treat ankylosing spondylitis (AS), and are now produced by Indian companies at lower costs. These inhibitors are also effective for conditions like IBD-associated arthritis and psoriatic arthritis.

What side effects do these medicines have?
Many avoid biological drugs due to misconceptions about their side effects. They fear these drugs will compromise the immune system, leading to further health issues. Biologics don’t harm the immune system, they correct its response instead. But JAK inhibitors may not be suitable for older individuals with ischemic heart disease or those with very low white blood cell and platelet counts. And, like biological drugs, JAK inhibitors can also reactivate dormant tuberculosis. Patients must make informed decisions.