Infusion Treatments for Rheumatoid Arthritis

If you have rheumatoid arthritis (RA), your doctor may suggest you get an infusion treatment -- medicine that goes into your body through a needle they place in a vein.

One type of medication that you may take as infusions are biologic drugs. Some also come as injections that you give yourself at home. To get an infusion, you'll need to go to a doctor's office or clinic.

Biologic drugs bring down inflammation in your body to prevent joint damage. Your doctor might put you on one of these drugs if your symptoms haven't improved with a disease-modifying drug like methotrexate.

Infusions vs. Injections

You give yourself injected drugs with a needle under your skin. A health care professional gives you infusions through a needle that they place into a vein in your hand or arm.

There are pros and cons to both methods. An infusion may be a better option if you don't like to give yourself shots and you don't want to take your medicine as often.

You'll need to take some injected medicines once a week or every other week. Infusions start with doses once a week or every other week. After a few treatments, you can stretch out the doses to once a month or longer, depending on the drug.

One downside to infusions is that you have to travel to a special center to get them. And it takes between 30 minutes and 4 hours to get each infusion.

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Infusion Treatments for RA

Four biologic drugs for RA come as infusions:

Abatacept (Orencia). It attaches to and blocks the action of cells that promote inflammation. You'll get an infusion once every 2 weeks to start. Then you'll get the drug once a month. Each infusion takes 30 minutes. You may not see the full effects of abatacept until you've been on it for 3 months or longer.

Infliximab (Remicade). This belongs to a group of drugs called TNF-inhibitors. They block a substance called tumor necrosis factor (TNF) in your blood that promotes inflammation. Each infusion can take up to 4 hours. You'll get three infusions in the first 6 weeks of treatment, and then once every 8 weeks. Your symptoms may start to improve after two to three doses.

Rituximab (Rituxan). This medication belongs to a group of drugs called B-cell inhibitors. You'll get two infusions spaced 2 weeks apart. You should improve on the medicine after about 3 months. The effects could last for up to a year.

Tocilizumab (Actemra). It blocks an inflammatory protein called IL-6. You get this infusion once every 4 weeks. Each infusion takes about an hour.

What to Expect During the Infusion

A doctor or nurse will check your temperature, blood pressure, and pulse before you start. They'll monitor these vital signs throughout your treatment.

You'll feel a pinch when they put a needle into your arm, but the infusion itself shouldn't hurt. You may get medicine before your treatment to relax you if you're nervous. While the medicine goes in, you can read a book or watch a movie.

Side Effects of Infusion Treatments

Infusions can cause mild reactions like:

You may get medicine before your treatment to prevent these side effects, such as:

Less often, infusions cause more serious reactions, with symptoms like:

Rarely, the reaction can be severe. If you have these symptoms, your doctor will stop the infusion and treat your symptoms.

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Because biologic drugs weaken your immune system, they can increase your risk for infections like colds, the flu, or pneumonia. Your doctor will test you for tuberculosis and hepatitis B and C before your treatment. You'll need to take extra care after you have infusions to avoid getting sick.

Some of these drugs may raise your risk for certain cancers if you take them for a long time.

In rare cases, people who take tocilizumab get a hole in the wall of their intestine. Tell your doctor right away if you have belly pain or blood in your bowel movement while you take this drug.

WebMD Medical Reference Reviewed by David Zelman, MD on April 27, 2020

Sources

SOURCES:

American College of Rheumatology: "Abatacept (Orencia)," "Rituximab (Rituxan and MabThera)," "TNF Inhibitors," "Tocilizumab (Actemra)."

Arthritis Care & Research: "2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis," "Tocilizumab (Actemra)."

Arthritis Foundation: "Biologics."

CreakyJoints.org: "Getting Biologic Infusions for Arthritis: 12 Common Questions, Answered."

FDA: "Highlights of Prescribing Information: Actemra." "Highlights of Prescribing Information, Rituxan."

Johns Hopkins Arthritis Center: "Rheumatoid Arthritis Treatment."

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