The New Era of Arthritis Treatment: Biologic Therapy

More recently, thanks to scientific breakthroughs in molecular biology and genetic engineering, we have a better understanding of the role of T cells, B cells, and chemical mediators in RA and other autoimmune diseases. T-cells and B-cells, like the White House and The Pentagon, communicate with each other and give orders, let’s say to attack. Tumor necrosis factor (TNF), IL-1, IL-6 or other cytokines, released from white blood cells after receiving the order, are key chemical mediators that can cause inflammation and joint damage. However, if communication between T cells and B cells is interrupted, or if B cells are eliminated, inflammation and joint damage can be impeded and even prevented.

In 1974, W. Kohler and C. Milstein developed a process for generation of specific antibodies which can bind the target cells and chemical mediators. Since then, researchers are able to produce the desired antibodies (biologics) for specific therapeutic purpose. In the past decade, with the development of biologic drugs, the treatment of rheumatoid arthritis and other autoimmune diseases enters the new era.

The biological activity of TNF is mediated by binding TNF to receptors which then trigger the inflammatory cascade. Like antimissiles, anti-TNF agent can lock in on target (TNF) and block the enemy’s offensive maneuvers. Currently, there are five anti- TNF agents including Enbrel, Humira, Remicade, Simponi and Cimza. Anti-TNF agents can also be used to treat psoriatic arthritis, inflammatory bowel disease and ankylosing spondylitis. Acterma and Kevzara (sarilumab), blocking IL-6 receptor are also effective treatment for RA. Anakinra, blocking IL-1, is especially effective treatment for juvenile RA.

Finally, there are two other different types of biologics for treatment of RA. The first is Orencia which inhibits the activation of T cells and helps relieve joint inflammation. The second is Rituxan which targets and depletes B cells. Rituxan is also approved for treatment of Wegener’s granulomatosis and microscopic polyangiitis. In the past few years, the FDA has approved two oral biologics- Xelianz (tofacitinib) and Olumiant (baricitinib) for the treatment of RA. Xelianz and Olumiant are oral JAK (Janus Kinase) inhibitors. Unlike other biologics that target extracellular molecules, such as proinflammatory cytokines, Xelianz and Olumiant target the intracellular signaling pathways that operate as hubs in the inflammatory cytokines network. Even though severe RA and other autoimmune diseases can be debilitating, the new biologic drugs give us good reason to be optimistic.

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A deep dive into musculoskeletal pain…

In this book, Dr. Tsai aims to offer readers a wider and deeper view of osteoarthritis, soft tissue rheumatism, and osteoporosis. Musculoskeletal pain is very common, but often misdiagnosed, and, therefore, treatment can be misguided. Not all pain should be dismissed as osteoarthritis, as several other conditions exist that may be the source of pain. To clarify the subtleties of this issue to readers and health providers, Dr. Tsai grouped the chapters anatomically and emphasized the similarities and differences of their symptoms, unique locations, and different treatment options. The main goal of this book is to help prevent patients and healthcare providers from being misguided by relying on X-ray, CT scan, and MRI findings alone.

This book is broken into three parts:

Part 1 focuses on the causes and symptoms of osteoarthritis and soft tissue rheumatism. Topics are organized anatomically, discussing OA and soft tissue rheumatism in various sections of the body.

Part 2 lists some treatment options for osteoarthritis, including pharmacological treatments, dietary supplements, exercise, and regenerative treatments.

Part 3 discusses osteoporosis, going through causes, symptoms, and treatment options.

Osteoarthritis, Soft Tissue Rheumatism, & Osteoporosis was written to be easily read by anyone, no matter their level of medical knowledge. Additionally, several illustrations are included to help visualize concepts and make them easier to grasp.

This book can be purchased online as an eBook or as a physical copy at our main office at the checkout desk or over the phone.

Arthritis, Autoimmune Disorders, & Allergy Cover

Arthritis, Autoimmune Disorders, & Allergy

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Dr. Tsai organizes several of these articles together to discuss common arthritis, autoimmune, and allergy conditions. The goal of this book is to help those who may be suffering from arthritis, autoimmune disorders, or allergies gain a better understanding of what they’re feeling and how their condition may be treated.

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For several years, Dr. Tsai has been writing bi-weekly medical columns for The Daytona Beach News-Journal. In this book, Dr. Tsai organizes several of these articles together to discuss common arthritis, autoimmune, and allergy conditions. The goal of this book is to help those who may be suffering from arthritis, autoimmune disorders, or allergies gain a better understanding of what they’re feeling and how their condition may be treated.

This book is broken into three parts:

Part 1 focuses on inflammatory arthritis conditions and their treatments. These include rheumatoid arthritis and psoriatic arthritis. (For information about osteoarthritis, check out Dr. Tsai’s second book:
Osteoarthritis, Soft Tissue Rheumatism, & Osteoporosis)

Part 2 looks at some autoimmune disorders and analyzes their causes, symptoms, and treatments.
Topics in this section include lupus and vasculitis.

Part 3 discusses allergies. The section explains types of allergic reactions, how they work, types of allergies, and how they can be treated.

Arthritis, Autoimmune Disorders, & Allergy was written to be easily read by anyone, no matter their level of medical knowledge. Additionally, several illustrations and photos are included to help visualize concepts and make them easier to grasp.

This book can be purchased online as an eBook or as a physical copy at our main office at the checkout desk or over the phone.

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