Treating RA: Choosing The Right Biologic for You
Biologics by Injection or Infusion
In choosing a biologic, you may want to consider how it’s taken. Some biologics are injected under the skin, which you can do at home. Others are infused --given by IV -- at a medical facility. Currently there aren't any oral biologics for RA.
People can give themselves injections or have a friend or family member do it for them. In general, injections need to be done more often than infusions -- anywhere from daily to every two weeks -- depending on the biologic.
Botvin gives herself injections using an auto-injector, which lets her inject herself without seeing the needle. Although Botvin likes the precision -- the auto-injector comes prefilled with exactly the right amount of medication -- she says the injections do tend to sting.
If you take a biologic by infusion, how often you take it can range from once every four to eight weeks. For each infusion, you would spend from 30 minutes to several hours in the doctor’s office, clinic or hospital.
Some people get serious infusion reactions, including chest pain, a change in blood pressure, difficulty breathing, and hives. One of the most serious risks of biologics, however, is that they pose an increased risk of the body’s vulnerability to infections and other diseases. In addition, patients need to be screened for tuberculosis before starting most biologics and then monitored for disease activation during treatment.
Working With Your Doctor On a Biologic
Choosing which biologic to take may take a lot of doctor-patient cooperation because so much is still unknown about them. “Selecting the right drug for a patient is a matter of trial and error,” Theodore Fields, MD, clinical director, Early Arthritis Initiative, at Hospital for Special Surgery tells WebMD. “Researchers are looking for ways to predict the best match. For now, we try one and if that doesn’t work, we try another.”
For this and many other reasons, your relationship with your doctor can make a big difference in RA treatment. “Find a rheumatologist you can talk with openly about your condition, medications, risks, and side effects,” says Elena Massarotti, MD, co-director of the Center for Clinical Therapeutics at Brigham and Women’s Hospital. “Your doctor can tell you what’s new so you always know what options are available.”