Biologic Treatments in Rheumatology: How They Work & When They're Used

In this short video, Dr. Bassel Darwish, Consultant Rheumatologist at Health Call Clinic in Dubai Healthcare City, explains what biologic medicines are, how they work, and when they may be considered in inflammatory and autoimmune rheumatic disease.

Biologics are targeted medicines that block specific molecules or cells driving inflammation, rather than suppressing the immune system broadly. Because they act on defined pathways, they can be highly effective when inflammation is not adequately controlled by conventional treatment — and they are chosen individually, based on the diagnosis, disease activity, other medical conditions, and patient preference.

When biologic treatment may be considered

Biologic therapy is usually discussed when inflammation remains active despite first-line treatment, when disease is severe from the outset, or when conventional medicines are not tolerated. Conditions where biologics are commonly used include:

• Rheumatoid arthritis
• Psoriatic arthritis
• Ankylosing spondylitis and axial spondyloarthritis
• Lupus and related autoimmune disease
• Selected periodic fever and autoinflammatory syndromes

Targeted biologic therapy may also have a role in selected difficult inflammatory situations — for example, some resistant cases of gout — but this is a specialist decision and is not routine long-term gout treatment.

Safety: screening before treatment and monitoring afterwards

Because biologics modify part of the immune response, preparation matters:

• Screening for infections such as tuberculosis and hepatitis before starting
• Reviewing and updating vaccinations where appropriate
• Regular blood tests and clinical review during treatment
• A clear plan for what to do during infections, surgery, or pregnancy planning

Why treatment selection is individualized

There is no single best biologic. The right choice depends on the diagnosis, how the disease behaves, other conditions such as psoriasis, uveitis, or inflammatory bowel disease, previous treatment response, and practical factors including how the medicine is given. The goal is to control inflammation well enough to protect joints and organs from long-term damage while keeping treatment as safe as possible. You can read more about inflammatory and autoimmune arthritis and about arthritis treatment options in Dubai.

Frequently Asked Questions

What are biologic medicines?

Biologics are treatments produced from living cell systems that target specific molecules or cells involved in inflammation, rather than suppressing the whole immune system.

Are biologics only used when other treatments fail?

Not always. They are often considered when inflammation persists despite conventional treatment, but they may be introduced earlier when disease is severe or when other medicines are unsuitable.

What tests are needed before starting a biologic?

Screening usually includes tests for tuberculosis and hepatitis, baseline blood tests, and a review of vaccinations. Your rheumatologist will tailor this to your history.

How long is biologic treatment continued?

This varies. Treatment is reviewed regularly, and decisions about continuing, adjusting, or changing therapy depend on disease control, side effects, and individual circumstances.

Would you like to discuss biologic treatment?

Our consultant rheumatologist provides individualized assessment of inflammatory and autoimmune rheumatic disease, including whether biologic therapy is appropriate. You can request an appointment on WhatsApp, book online, or learn more about rheumatology at Health Call Clinic. You can also read about Dr. Bassel Darwish.

This video provides general educational information and is not a substitute for an individualized assessment, diagnosis, or treatment plan. Decisions about biologic therapy should be made with an appropriately qualified rheumatologist.