Track Biologics

Track Biologics

Biologics are often helpful in treating RA. They work with the immune system to control inflammation. Like any medication, they have side effects you'll want to watch for. Learn tips on what to look for, and get some other suggestions on using biologics safely and effectively.

Conditions: Rheumatoid arthritis

Symptoms: Symptoms worse in A.M., weakness, fever, reduced joint movement, stiffness, stiffness after rest, deformed joint, stiff joint, swollen joint, warm joint, joint pain, muscle pain, pain, symmetrical pain

Treatments:

Categories: Treatment

Duration

14

Be Patient

If you're just starting a biologic, you may not feel better overnight. Ask your doctor when you should start to feel an effect. Depending on the drug you take, you may not see a change in your symptoms for several weeks. In the meantime, try to be patient and give your medication time to work.

Prompt: Be patient.

CTA: Biologics take time to work.

Conditions: Rheumatoid arthritis

Symptoms: Loss of appetite, fatigue, feeling sick, symptoms worse in A.M., weakness, fever, lumps under skin, reduced joint movement, stiffness, stiffness after rest, anxiety, depression, deformed joint, stiff joint, swollen joint, warm joint, joint pain, muscle pain, pain, lower back pain, upper back pain, symmetrical pain, numbness, tingling

Triggers:

Treatments: abatacept, adalimumab, anakinra, certolizumab, etanercept, golimumab, infliximab, rituximab, tocilizumab, methotrexate, Rheumatrex, plaquenil, hydroxychloroquine, azulfidine, sulfasalazine, Arava, leflunomide, Actemra, Cimzia, Enbrel, Humira, Kineret, Orencia, Remicade, Rituxan, Simponi,  Trexall

Categories: Treatment

Checking In

When you first start taking a biologic, you may need to see your doctor as often as every few weeks. That could seem like a lot -- and inconvenient -- but frequent checkups are important at the beginning. Your doctor needs to make sure the drug is working and watch out for side effects. Once your treatment plan is settled, you'll need visits less often.

Prompt: Starting a biologic?

CTA: Get regular checkups.

Conditions: Rheumatoid arthritis

Symptoms: Loss of appetite, fatigue, feeling sick, symptoms worse in A.M., weakness, fever, lumps under skin, reduced joint movement, stiffness, stiffness after rest, anxiety, depression, deformed joint, stiff joint, swollen joint, warm joint, joint pain, muscle pain, pain, lower back pain, upper back pain, symmetrical pain, numbness, tingling

Triggers:

Treatments: Prescription medications, abatacept, adalimumab, anakinra, certolizumab, etanercept, golimumab, infliximab, rituximab, tocilizumab, methotrexate, Rheumatrex, plaquenil, hydroxychloroquine, azulfidine, sulfasalazine, Arava, leflunomide, Actemra, Cimzia, Enbrel, Humira, Kineret, Orencia, Remicade, Rituxan, Simponi, Trexall

Categories: Treatment

Infection Risk

People on biologic therapy are at increased risk for serious infections. If you get signs of an infection while using a biologic -- such as a fever, breathing problems, or an urge to urinate frequently or burning when urinating   -- see your doctor right away. If you do have an infection, your doctor may stop giving you a biologic for a while to give your immune system a boost. You may also need an antibiotic. Once the infection has cleared, your doctor will usually restart you on biologic therapy. Note that before you start a biologic, your doctor will test you to make sure you haven't been exposed to tuberculosis.

Prompt: Signs of infection?

CTA: When to call your doctor.

Conditions: Rheumatoid arthritis

Symptoms: Loss of appetite, fatigue, feeling sick, symptoms worse in A.M., weakness, fever, lumps under skin, reduced joint movement, stiffness, stiffness after rest, anxiety, depression, deformed joint, stiff joint, swollen joint, warm joint, joint pain, muscle pain, pain, lower back pain, upper back pain, symmetrical pain, numbness, tingling

Triggers:

Treatments: Prescription medications, abatacept, adalimumab, anakinra, certolizumab, etanercept, golimumab, infliximab, rituximab, tocilizumab, methotrexate, Rheumatrex, plaquenil, hydroxychloroquine, azulfidine, sulfasalazine, Arava, leflunomide, Actemra, Cimzia, Enbrel, Humira, Kineret, Orencia, Remicade, Rituxan, Simponi, Trexall

Categories: Treatment

Skin Reactions

Have you noticed burning, itching, or a rash in the area where you inject your biologics? That's one of the most common side effects. About 1 out of 3 people using a biologic get these type of symptoms at the injection site. If you have any of these symptoms, tell your doctor. He or she may recommend a cream to soothe the irritation. Rotating sites where you give the injection can help.

Prompt: Skin problems?

CTA: Get help for this side effect.

Conditions: Rheumatoid arthritis

Symptoms: Loss of appetite, fatigue, feeling sick, symptoms worse in A.M., weakness, fever, lumps under skin, reduced joint movement, stiffness, stiffness after rest, anxiety, depression, deformed joint, stiff joint, swollen joint, warm joint, joint pain, muscle pain, pain, lower back pain, upper back pain, symmetrical pain, numbness, tingling

Triggers:

Treatments: Prescription medications, abatacept, adalimumab, anakinra, certolizumab, etanercept, golimumab, infliximab, rituximab, tocilizumab, methotrexate, Rheumatrex, plaquenil, hydroxychloroquine, azulfidine, sulfasalazine, Arava, leflunomide, Actemra, Cimzia, Enbrel, Humira, Kineret, Orencia, Remicade, Rituxan, Simponi, Trexall

Categories: Treatment

Prevent Listeriosis

Biologics can increase the risk of listeriosis, a bacterial infection often associated with eating contaminated food. If you're taking a biologic medication, protect yourself by always washing produce and cooking meat and poultry thoroughly before eating.  Also avoid eating foods such as unpasteurized cheese and milk, cold cuts, and hot dogs. They have a higher risk of listeria contamination.

Prompt: Food-borne infections.

CTA: Biologics increase the risk.

Conditions: Rheumatoid arthritis

Symptoms: Loss of appetite, fatigue, feeling sick, symptoms worse in A.M., weakness, fever, lumps under skin, reduced joint movement, stiffness, stiffness after rest, anxiety, depression, deformed joint, stiff joint, swollen joint, warm joint, joint pain, muscle pain, pain, lower back pain, upper back pain, symmetrical pain, numbness, tingling

Triggers:

Treatments: Prescription medications, abatacept, adalimumab, anakinra, certolizumab, etanercept, golimumab, infliximab, rituximab, tocilizumab, methotrexate, Rheumatrex, plaquenil, hydroxychloroquine, azulfidine, sulfasalazine, Arava, leflunomide, Actemra, Cimzia, Enbrel, Humira, Kineret, Orencia, Remicade, Rituxan, Simponi, Trexall

Categories: Treatment

Side Effect Help

Are the side effects of biologic therapy bothering you? Don't manage them on your own by skipping or cutting down on doses. If you're not getting the amount of medication you need, your RA could get worse. Instead, see your doctor and emphasize how much the side effects are bothering you. Together, you can work out a solution. Your doctor may treat the side effects, or he may adjust your dose or change your treatment.

Prompt: Bothered by side effects?

CTA: Talk to your doctor.

Conditions: Rheumatoid arthritis

Symptoms: Loss of appetite, fatigue, feeling sick, symptoms worse in A.M., weakness, fever, lumps under skin, reduced joint movement, stiffness, stiffness after rest, anxiety, depression, deformed joint, stiff joint, swollen joint, warm joint, joint pain, muscle pain, pain, lower back pain, upper back pain, symmetrical pain, numbness, tingling

Triggers:

Treatments: Prescription medications, abatacept, adalimumab, anakinra, certolizumab, etanercept, golimumab, infliximab, rituximab, tocilizumab, methotrexate, Rheumatrex, plaquenil, hydroxychloroquine, azulfidine, sulfasalazine, Arava, leflunomide, Actemra, Cimzia, Enbrel, Humira, Kineret, Orencia, Remicade, Rituxan, Simponi, Trexall

Categories: Treatment

Planning a Trip?

Planning a vacation? Remember that most biologics need to be kept cool. Transport them in a cooler with ice packs. If you're staying in a hotel, call ahead to make sure that there's a fridge in your room. What if you forget and accidentally let your biologic medication warm up? Call your doctor to find out what you should do. He can tell you if it's still OK to use the meds.

Prompt: Planning a trip?

CTA: Keep biologics cool.

Conditions: Rheumatoid arthritis

Symptoms: Loss of appetite, fatigue, feeling sick, symptoms worse in A.M., weakness, fever, lumps under skin, reduced joint movement, stiffness, stiffness after rest, anxiety, depression, deformed joint, stiff joint, swollen joint, warm joint, joint pain, muscle pain, pain, lower back pain, upper back pain, symmetrical pain, numbness, tingling

Triggers:

Treatments: Prescription medications, abatacept, adalimumab, anakinra, certolizumab, etanercept, golimumab, infliximab, rituximab, tocilizumab, methotrexate, Rheumatrex, plaquenil, hydroxychloroquine, azulfidine, sulfasalazine, Arava, leflunomide, Actemra, Cimzia, Enbrel, Humira, Kineret, Orencia, Remicade, Rituxan, Simponi, Trexall

Categories: Treatment

Switching Biologics

Sometimes a biologic that worked very well can eventually stop helping. It can be discouraging.  However, take heart.  Your doctor likely has other potentially effective biologic treatments to choose from. Switching biologics and changing medication strategy could help.

Prompt: Drug stopped working?

CTA: Switching biologics.

Conditions: Rheumatoid arthritis

Symptoms: Loss of appetite, fatigue, feeling sick, symptoms worse in A.M., weakness, fever, lumps under skin, reduced joint movement, stiffness, stiffness after rest, anxiety, depression, deformed joint, stiff joint, swollen joint, warm joint, joint pain, muscle pain, pain, lower back pain, upper back pain, symmetrical pain, numbness, tingling

Triggers:

Treatments: Prescription medications, abatacept, adalimumab, anakinra, certolizumab, etanercept, golimumab, infliximab, rituximab, tocilizumab, methotrexate, Rheumatrex, plaquenil, hydroxychloroquine, azulfidine, sulfasalazine, Arava, leflunomide, Actemra, Cimzia, Enbrel, Humira, Kineret, Orencia, Remicade, Rituxan, Simponi, Trexall

Categories: Treatment

WebMD Medical Reference Reviewed by Sabrina Felson, MD on November 03, 2019

Sources

SOURCES:

University of Pennsylvania School of Medicine, MedPage Today: "Biologics and Combinations Top Arthritis Recommendations."

American College of Rheumatology 2008 Recommendations for the Use of Nonbiologic and Biologic Disease-Modifying Antirheumatic Drugs in Rheumatoid Arthritis.

Arthritis Today: "Drug Guide: "Biologics," "When Should I See My Doctor?" "If In Remission, Can I Stop Medication?"

American Academy of Rheumatology: "Biologic Treatments for Rheumatoid Arthritis."

AARP Bulletin: "The High Cost of Biologics."

Arthritis Foundation: "Biologics: Learn About These Treatments for Rheumatoid Arthritis and Other Diseases" and "Remission and Flares."

NIH, Medline Plus: "Rheumatoid Arthritis."

Pediatric Rheumatologist: "Medications."

Clifton Bingham, MD, associate professor of medicine, Johns Hopkins University; associate director, Johns Hopkins Arthritis Center, Baltimore.

Eric L. Matteson, MD, chair, department of  rheumatology, Mayo Clinic, Rochester, Minn.

Saag, K. Arthritis & Rheumatism, June 15, 2008.

National Institute of Arthritis and Musculoskeletal and Skin Diseases: "Rheumatoid Arthritis."

UpToDate.

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