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    If Your Biologic for RA 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’s a good reason to stay optimistic.

    That’s because most people eventually find one that helps them. And when you do, it may ease your symptoms or cause them to fade completely.

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

    But if your symptoms don’t improve, let your doctor know. The goal is to find the best medicines for you as quickly as possible. 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 (Inflectra, Remicade)

    If the first anti-TNF you try doesn’t work for you, your doctor will most likely try 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.”

    Sometimes, 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’ll probably switch you to another biologic or add another type of RA drug, like methotrexate or sulfasalazine, so your treatment works better. 

    Some people get more help from biologics than others. Experts can’t predict who’ll respond well and who won’t. But they know that people who get treatment in the earlier stages of RA tend to do better than those who’ve had the disease 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, ask your doctor about your options.

    WebMD Medical Reference

    Reviewed by Melinda Ratini, DO, MS on January 15, 2017

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