1.Which patients are suitable for biologics? Biological agents are mainly suitable for patients with moderate or severe psoriatic arthritis or psoriatic arthritis in which traditional drug treatment is not effective. 2.Is it necessary to use immunosuppressants, folic acid, etc. after using biological agents? For patients with psoriatic arthritis, when applying biological agents, methotrexate is usually also applied in combination, which can enhance the efficacy on the one hand, and on the other hand, when the biological agents are discontinued, methotrexate is continued to be taken, which can reduce the recurrence of the disease. Methotrexate is the opposite of folic acid in the body, which can inhibit the growth and reproduction of tumor cells and immune inflammatory cells. This is the basis for its ability to treat both tumors and immune disorders. Methotrexate rarely causes serious side effects if used only in small doses each week. Its common side effects include, mouth ulcers or stomatitis, stomach upset, nausea, loss of appetite, and elevated liver transaminases (liver function impairment). Occasionally, bone marrow suppression (blood leukopenia and thrombocytopenia), hair loss, and pulmonary fibrosis may occur. Taking 1 tablet (5mg) of folic acid on the 2nd or 3rd day of weekly methotrexate administration significantly reduces methotrexate-induced adverse effects such as mouth ulcers, elevated liver transaminases, and gastrointestinal discomfort without reducing the efficacy of methotrexate. However, if you take folic acid daily, it will not only antagonize methotrexate, but also reduce the absorption of methotrexate, lower its blood concentration, and decrease its efficacy. I often find patients who take 1-2 tablets (5-10mg) of folic acid every day to reduce the efficacy of methotrexate, resulting in the condition not being effectively controlled. 3. Do I need to go to a big hospital for injections of biologics, or can I buy them and go to a community hospital for injections? Or can I inject it myself? The injection method of biological agents varies depending on the variety (see the table above), except for the class of gram, which must be injected intravenously in a large hospital, the other drugs are injected subcutaneously and can be injected in a community hospital. Because the drug has been pre-filled in the syringe, patients can even inject themselves subcutaneously Xumel, Enzyme. 4. What are the most important adverse reactions of biological agents now? How high is the incidence? The most important adverse reactions of Ixepro and Qiangk are redness and itching at the injection site, with an incidence of about 5-10%. The incidence of infusion reactions may occur during intravenous dripping of Classic, which can be reduced to less than 1% by slowing down the drip rate, therefore, intravenous dripping of Classic must be done in an experienced hospital. All of these biological agents may increase the incidence of infections (about 1-2%), such as pneumonia, hepatitis B recurrence, and tuberculosis recurrence. Therefore, biologics should not be applied in patients who are particularly weak or are co-infected. Hepatitis B virus carriers or those with latent tuberculosis infection need to be especially careful when applying biological agents. 5.Does biologic agents really increase the risk of getting cancer? The biologics that have been marketed for the treatment of psoriatic arthritis mainly block tumor necrosis factor (TNF), so some people worry that the application of these drugs will increase the occurrence of tumors. The incidence of lymphoma, hematologic tumors, and parenchymal organ tumors is higher in patients using these drugs than in patients not using these biologics. In short, the available evidence proves that biologics do not increase the risk of developing cancer. However, biologics are generally not recommended for patients with existing tumors or patients who have had tumors. 6.To what extent of control can biologics be discontinued? There is a lack of clear and reliable criteria for discontinuation of biologics. It is generally recommended that after psoriatic arthritis has returned to remission, the dosage of biological agents can be reduced and the treatment can be consolidated by combining with immunosuppressive agents (increasing the dose of methotrexate or combining with other immunosuppressive agents). The possibility of relapse is very high if the biologics are suddenly stopped and no oral immunosuppressants are administered. After a sustained remission of more than 1 year, biological agents can be discontinued and oral immunosuppressive agents alone can be used for maintenance treatment.