Biologic Drugs in Autoimmune Diseases

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Background

In the current therapy of autoimmune disease, a significant progress has been made in terms of introducing novel, mostly biologic, drugs in place of chemical molecules. These biologic agents enhance or replace conventional immunosuppressive therapies. Their mechanism of action consists in disrupting the inflammatory process. The categories of biologics include inhibitors of tumor necrosis factor, interleukins, T cells, B cells, or JAK. Biologics, or biologic-response modifiers, may be prescribed for the treatment of autoimmune diseases, including many types of arthritis (e.g., rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis), as well as inflammatory bowel diseases or psoriasis. Biologics exert significant clinical effects at various stages of the disease process, providing a considerable and long-term benefit to patients, particularly those who failed or did not tolerate standard treatment. Their mechanism of action is still on the research agenda in pharmacology.

Owing to a rapid progress in the development of biologic therapy, it is important to disseminate up-to-date information on new clinical data. Research Topic papers are aimed at providing a comprehensive review of current biologic therapies used in the treatment of autoimmune diseases, based on systematic reviews and meta-analyses. While direct comparisons for biologics are quite rarely an option for clinical trials and no robust data are available, indirect comparisons (NMA; Network Meta-analysis) could provide relevant and comprehensive data for the relative efficacy and safety assessment.n As clinical head to head comparisons for biologics are largely lacking, NMA studies are particularly useful and needed, as they are crucial for informing us on medical treatment paradigms.

Another important issue is the assessment of the relative safety profile of biologics, as due to relatively short follow-up periods, only limited data on adverse events are available. The costs and cost-effectiveness are also crucial aspects to consider in studies on biologic therapy. On one hand, the unit cost of a biologic drug is often much higher compared with that of standard medicines. On the other hand, the use of biologics results in significantly lower rates of disease progression. Additionally, in some diseases, biologics delay or prevent costly medical procedures, such as surgeries. Finally, the use of biologics translates into a significant improvement in the quality of life of patients with autoimmune disease.

The objective of this Research Topic is to provide new insights into all the important aspects of using biologic drugs in the treatment of autoimmune disease. We will focus not only on clinical effectiveness and safety issues but also on cost-effectiveness studies. Scientific contributions from all relevant stakeholders including academia, industry, and regulatory authorities are welcomed.

Keywords: Biologics, biologic drugs, autoimmune, efficacy, safety, efficiency, review

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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