Eeny, Meeny, Miny, Bio. Using Biologics for RA when Your Illness Isn't Under Control
Recently, RheumatoidArthritis.net conducted its 8th Annual RA In America Survey and the results were, frankly, surprising. At least to me, they were. Maybe there’s some RA-based statistical goddess out there who is made of slide rules and eats 12-sided die with milk like rice crispies every morning, but I’m just a regular, non-mathematically inclined human being. Hmm, idea for breakfast cereal – 12-sided dyno-bites?
No experience with an RA biologic
I digress. The point is, ladies and gentlemen and everyone in-between, the survey results showed that only about 16 percent of respondents felt like their RA was under control. And, the craziest part - more than half of the respondents (“more” meaning 51 percent – hey, it’s technically true) have not tried biologics because their physicians have never recommended them!
Sounds crazy, no? But here, in our little village of RheumatoidArthritis.net, you might say every one of us has been in that 51 percent at one time or another. Trying to scratch out a pleasant simple life without using heavy medications for one reason or another. Sorry, the Fiddler on the Roof soundtrack just came on and I couldn’t resist. But my musical proclivity for show tunes aside, it’s criminal that such a small number of people who suffer from RA are getting relief!
Their RA is not under control
Sixteen percent of respondents under control. That means eighty-four percent aren’t under control! Think about how large that number is. If you won the lottery and someone said, “Well, there’s been an error and you’re only getting 84 percent of the 100 million dollars,” that’s STILL 84 MILLION DOLLARS.
In other words, the vast majority of people with RA who responded are living lives where their disease is not under control. I think that’s a large enough number where we can just say that most people with rheumatoid arthritis feel like their illness isn’t being controlled with the medication they are currently taking, which brings us to the next number.
Physician have not recommended biologic DMARDs
Half. Half of the people have physicians that have never recommended biologics. Half. Not because their insurance wouldn’t pay for it or because they had an adverse reaction, no. But simply because of the fact that their doctors never recommended it. This is the part that is difficult for me to wrap my head around.
There is no excuse
It’s been more than fifteen years since the first bio, Enbrel, came out. I know because I was one of the first to try it, and it was harder to get than gate information at an airport. C-9? C-19? Wait... C1-9? Nevermind, I'll swim to Europe. So, for fifteen years biologics have been available now, there’s no excuse for a rheumatologist to not know about them. It’s not like they are the new hottest, fresh off the... off the... hmm, well, I’m not sure exactly what biologic medications come fresh off of. Fresh off the petri dish? We’ll go with that. So, it’s not like biologic medications are fresh off the petri dish!
What is a biologic DMARD?
In the last decade and a half, more than ten different biologic medications have been released and more are coming every year. Just in case some of you don’t know what a biologic medication is, we’ll do a quick refresher.
Biologic medications inhibit different parts of the immune system, like B cells and T cells and TNF, in order to help suppress the immune response that’s causing that particular patient’s rheumatoid arthritis. And if you aren’t fluent in science, all of that just means that biologic medication gives your immune system a big ol’ kick right in the molecules and makes the RA go away.
Biologics: a game-changer for autoimmune conditions
It’s been a game-changer in the field of autoimmune disease and has become the de facto treatment method preferred by many prominent rheumatologists, which is why it’s so shocking that over half of our respondent’s doctors haven’t recommended any of them!
Let me put it into context. A rheumatologist not recommending a biologic medication would be like a car salesman not recommending you buy a car and giving you a bike. A used one. One with a broken front wheel spoke and rainbow stickers half peeled off the back fender. Also, it has no seat.
Advocate for your RA treatment
So, you’re probably going to ask, “What should I do, oh great and wise author of this post?” Well, first, thank you for the compliment. I guess I am wise but great? Well, the jury’s still out.
Second, here’s what you can do – tell your doctor you want to try biologic medication! I can’t stress enough how much patients with RA and other chronic illnesses must be their own advocates. I know, I know - you’ve probably heard that so many times by now that you’re thinking of getting it as a face tattoo. Unfortunately, as cliché as it is, it’s also true.
You need to speak up and if your RA isn’t under control, as is the case in the majority of situations as this survey has astonishingly elucidated, you have every right to ask your physician to explore biologics and other avenues. Remember, doctors aren’t your parents and they aren’t Norse deities from Asgard (although I wouldn’t mind if my rheumatologist was one of the Hemsworthes. Hemsworthises? Hemsworthers.) You can and should talk back, raise your concerns, and assert yourself.
Shedding light on other treatment options
Eighty-four percent of you reading this will have RA that’s making your life miserable, and half of those haven’t even tried the medication for autoimmune illnesses that has been changing the game for over a decade.
This is borderline criminal and I truly hope that this post will help to not only shed some light on the subject but give you the push you might need to tell your doc it’s time to try biologics. Now, I have to call my own doctor. Paging Dr. Hemsworth…Talk soon.
The 8th Annual RA In America survey was conducted online from April 6 to June 25, 2020. A total of 3,511 people completed the survey.
When was your last flare?