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If Your RA Biologic Doesn’t Help Enough

It may take some trial and error to find the biologic that works best for your rheumatoid arthritis (RA), but there is good reason to stay optimistic.

Most people eventually find one that helps them. Your symptoms may ease somewhat or fade completely.

You should start to feel better 4 to 6 weeks. Your doctor may also prescribe other medicines that work faster to help you in the meantime.

If your symptoms don’t ease, tell your doctor. The goal is to find your best medicines as quickly as possible, since timely treatment helps protect your body from RA damage.

What to Expect

When your doctor first prescribes you a biologic, it’s usually an “anti-TNF” drug. These include:

  • Adalimumab (Humira)
  • Certolizumab (Cimzia)
  • Etanercept (Enbrel)
  • Golimumab (Simponi)
  • Infliximab (Remicade)

If the first anti-TNF you try doesn’t work for you, your doctor will most likely give another one. If you still don’t get relief, he may switch you to another type of biologic. These include:

  • Abatacept (Orencia), which blocks the immune system’s T-cells to lower inflammation
  • Anakinra (Kineret), which targets interleukin-1, a chemical your body makes that causes inflammation. Your doctor will call this type of drug an "IL-1 blocker."
  • Rituximab (Rituxan), which targets certain B-cells, which are part of your immune system
  • Tocilizumab (Actemra), which targets IL-6, a chemical your body makes that causes inflammation. Your doctor will call this type of drug an “IL-6 blocker.”

In some cases, biologic drugs will work for a while and then become less effective. It’s not clear why. If it happens to you, tell your doctor. He will probably change you to another biologic or add another type of RA drug, such as methotrexate or sulfasalazine, so your treatment works better.  

Some people get more help from biologics than others. Experts can’t predict that. But they know that people who are treated in the earlier stages of RA tend to do better than those who have had RA for many years.

Biologics also work best if you take them on a regular schedule. If you can’t do that due to side effects or the cost of the drugs, talk with your doctor about your options.

WebMD Medical Reference

Reviewed by David Zelman, MD on March 24, 2015

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