What Are Biologics?

Made from living sources, biologic medication treats a wide range of conditions — from psoriasis to diabetes to cancer.

You’ve probably heard drug names like Humira^®, Enbrel^®, Lantus^®, Cosentyx^® or BOTOX^® Cosmetic. In fact, chances are, you or someone you know has taken one of them. But did you know they’re a different class of medicine known as biologics?

Through biotechnology, biologic drugs are made from living sources, including humans, animals or microorganisms. They include a range of products, from vaccines to blood components to genes and allergenics. Typically, biologics are administered through a shot or intravenously (IV), and can be composed of sugars, proteins, or living substances like cells or tissues.

Biologics are one of the most advanced therapies available today to treat several types of diseases and conditions, including:

Cancer
Anemia
Plaque psoriasis
Rheumatoid arthritis
Diabetes
Multiple sclerosis
Crohn’s disease
Osteoporosis
Cosmetic enhancements

“Biologics have revolutionized treatment for various conditions by significantly improving patient outcomes and offering hope to those who previously had no effective treatment options available,” says Durga Zally, PharmD, Geisinger’s system director of pharmacy infusion oncology services.

How is biologic therapy different from traditional drugs?

Conventional medications are synthesized from chemical compounds, but biologics come from living organisms or their components. The process of biologic therapy involves extracting the essential genes, cells or proteins from living organisms. Laboratory scientists manipulate the components to enhance their therapeutic properties. Then these genes, cells or proteins are purified and made into biologic medications.

In general, biologic therapy works by targeting specific natural systems in the body that are impaired or overactive. For example, a biologic therapy might prevent inflammation, slow down overactive muscles or glands or prevent unchecked cell growth.

Traditional drugs come in the form of capsules, liquid and topical cream. Biologics are injected or infused because digestion can inactivate them if they’re taken by mouth.

Because biologics are derived from living substances, they tend to be heat sensitive and susceptible to microbial contamination.

“While they are generally more costly than traditional drugs due to their complex production process, biologics have shown promising results in managing and improving the quality of life for many patients with chronic conditions,” says Dr. Zally.

Types of biologics

Many biologic therapies have separate purposes — and they all work a little differently. For instance, vaccines protect from disease, blood products save lives in surgery, insulin treats patients with diabetes and antibodies treat those with autoimmune disorders or cancer.

Some of the general types of biologics include:

Monoclonal antibodies

Monoclonal antibodies are lab-produced antibodies that target specific proteins or antigens in the body to help your immune system destroy cells containing these antigens. They’re used to treat many autoimmune conditions, like rheumatoid arthritis, plaque psoriasis, Crohn's disease and multiple sclerosis, as well as certain types of cancer.

For example, biologics for rheumatoid arthritis target specific parts of the immune system that cause joint inflammation. Those that treat multiple sclerosis target the component that worsens inflammation in the central nervous system. For psoriasis, biologics suppress the overactive immune response that leads to the development of skin lesions.

Some of the many drug names for these types of biologics include:

Humira and Enbrel for rheumatoid arthritis
Cosentyx and Stelara^® for plaque psoriasis
Herceptin® and Avastin^® for cancer
Lucentis^® for macular degeneration
Evenity^® for postmenopausal osteoporosis

Growth factors

As their name indicates, growth factor biologics stimulate the growth and development of specific body cells and can affect their function. Therapeutic growth factors treat conditions like anemia and growth hormone deficiency, and can reduce side effects in chemotherapy patients.

For example, growth factors can treat patients with anemia caused by renal failure by stimulating production of red blood cells, or those receiving chemotherapy by stimulating the production of white blood cells.

Some drug names for growth factor biologics include:

Aranesp^® and Epogen^® for anemia
Neupogen^® and Neulasta^® for neutropenia

Vaccines

Immunizations against the flu, HPV and COVID are biologics, too. Vaccines stimulate your immune system to protect against specific diseases. They contain weakened or inactive antigens (or the blueprint for producing these antigens) to prompt your immune system to respond the same way it would to the actual pathogen.

Vaccines are one of the most powerful ways to reduce disease and save lives. In some cases, they have even helped eliminate certain diseases, such as smallpox and polio.

Other types of biologics include:

Allergenics
Antitoxins
Blood products, such as red blood cells or platelets
Botox
Gene therapies
Hormone replacement therapy
Immunotherapy
Recombinant proteins, such as insulin
Stem cell therapies
T-cell therapies

Do biologics have side effects?

Like any medication, biologics can cause side effects. But because they’re targeted treatments, they often cause fewer side effects than traditional drugs. It depends on the type, length of use, medical history and how well your body responds to the drug.

The most common side effect is a reaction at the injection site, including redness, itching, swelling or pain, which typically resolves on its own.

Other side effects can include:

Mild allergic reaction
Fever, chills
Headache
Flushing
Swelling
Nausea and upset stomach
Diarrhea
Rash
Fatigue

Because many biologics weaken the immune system, they can increase the risk of infection, leading to things like colds, bronchitis or urinary tract infection. The good news: You can help prevent infection by using good hand hygiene and avoiding crowded indoor spaces.

“Biologics also pose the risk of immunogenicity, where the body’s immune system could identify the biologic medication as a foreign substance and develop an unwanted immune response,” says Dr. Zally. “The response can reduce or eliminate the drug’s therapeutic effects and, in some cases, cause serious complications.”

She points to a few serious (but rare) reactions to biologics:

Trouble breathing
Severe allergic reaction
Chest pain or tightness
High or low blood pressure
Swelling of the face and hands
Increased risk of cancer

“While biologics do come with risks, as do all medications, the benefits can far outweigh them in many instances,” says Dr. Zally. “These medications are revolutionizing healthcare by introducing treatment options that allow us to better manage chronic conditions like diabetes, prevent widespread diseases and significantly extend the lives of people with cancer. Biologics herald a new era in medicine, providing targeted therapies for previously untreatable conditions and improving patient outcomes.”