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Infusions

I have recently started a trial of Rinvoq which i am concerned about the affects it can have on my whole body. If I decide to go to infusions what happens after infusions if it doesnt work either? I mean, I started on pills that didnt work then I went to enbrel shots until that no longer worked after 5 years on that so the only thing left seems to be infusions which I'm scared of as well (the infusion process and the risk of an allergic reaction during the infusion) but if that doesn't work where do I go from there? The rinvoq is a daily pill and after a week on that I got a sinus infection and had to stop it for a few days and instantly felt the pain as where the Enbrel was a weekly shot and when I had to go off that to get better it took about 5 days before I felt it and was about time to take my next shot anyways. It's sad to read all these people living with this much pain! I also wonder why scientist haven't came up with a treatment for RA using information that pregnant women who have RA are totally pain free while pregnant? There's got to be something to that that could be used to treat RA in everyone!

  1. Hi . Your concerns about the trial and error method of finding an RA treatment are certainly understandable. I do want to stress that when you mention going from an injection to a pill to an infusion and wondering what is next that there are actually multiple forms of each of these types of treatment and they all may work differently. For example: Enbrel is an TNF inhibitor. Humira is also a TNF inhibitor administered by a self-injection, but a person who had Enbrel cease to be effective many have success with Humira. There are actually quite a few biologics and this article from our editorial team gives an overview: https://rheumatoidarthritis.net/treatment/biologics-treatment-options-for-ra. The same is true for Rinvoq and other pill form JAK inhibitors (see: https://rheumatoidarthritis.net/living/jak-inhibitor-treatment).
    One of the reasons so many treatments are necessary and that it is so hard to find what will work is that RA is so individualistic, with different parts of the immune system seeming to be responsible to driving disease activity in different people. For example: recent research has found the interleuken-6 and interleuken-1 inflammatory molecules may be the primary drivers in juvenile RA cases. The hope is that research such as this will lead to biomarker testing that can identify which treatments are most likely to work for an individual. I know this is of limited use in the here and now, but want to illustrate that there is hope that finding treatments will get easier and that, for now, there are quite a few options your doctor should be able to discuss with you. Best, Richard (RheumatoidArthritis.net Team)

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