Biologic #9: Kevzara
In August, I did the first injection of my ninth biologic--Kevzara (sarilumab). Technically, it's my 10th biologic since the fall of 2002, because I've been on Remicade and Humira twice during that time span. Ten biologics, nine different ones, in 17 years. Is that good? Bad? Too much, too fast? I don't know anymore.
My biologic medication list is as follows: Enbrel, Remicade, Humira, Orencia, Remicade, Actemra, Xeljanz, Rituxan, Humira, and Simponi. It's hard to believe that all of these powerful drugs have coursed through my veins without a break since 2002.
Trying different RA biologics
Remicade lasted the longest and even let me get off of prednisone for extended periods of time, both times I was on it. Going back on it for a third time is not an option, however, because there's an almost 100% likelihood that it won't work again.
RA biologics that didn't work for me
However, the five drugs I tried after Remicade also failed: Actemra, Xeljanz, Rituxan, Humira, and most recently Simponi. Failure after failure like this has been difficult to cope with, often leaving me feeling very frustrated and demoralized. And it's something over which I have absolutely no control. My body decides its fate with these drugs, not me.
Am I running out of RA biologic options?
The word that comes to mind the most and strongest when I think about all of this is: worry. I'm running out of options (I think I have two biologics left?), and that's a very frightening and worrying situation to be in. The only treatment that has really helped during my 22 years of having RA has been biologic medication--when it worked, that is.
Try DMARDs and prednisone
Other DMARDs alone could not and did not help stop the relentless inflammation attacking my joints. The only other drug that significantly helps is prednisone; and we all know how the side effects of this powerful steroid can wreak havoc on one's body--especially when taken long-term.
Starting the biologic Kezvara
Kezvara is an interleukin-6 receptor blocker
So after the recent Simponi failure (which lasted over a year), it's time to try bi-weekly self-injections of Kevzara. Similar to Actemra, Kevzara is an interleukin-6 (IL-6) receptor blocker. Interleukin-6 is an immune system protein produced by the white cells in your blood. And IL-6 is believed to play a role in the symptoms of RA such as pain, swollen joints, morning stiffness, and fatigue.
Anti-TNF drugs like Simponi have not worked for me
Simponi, on the other hand, works by a different mechanism and is known as a TNF inhibitor. After having tried anti-TNF drugs six times, they just don't seem to be a good option anymore. Despite Actemra not working for me in the past, I'm hopeful that Kevzara will work, even if the two drugs are similar. Drugs can work (or not work) depending on many things. Each patient's body and RA is unique, which can make treating the disease so complicated and frustrating. You never know how your RA will respond to all of the different treatments out there. And sometimes a drug will work for a while and then stop for some reason.
Hoping for more advances in RA treatment
RA is such an erratic, unpredictable disease and this makes treating it extremely difficult. The good news is that science and technology continue to make progress with the development of new medications and treatments--which is crucial for us patients.
Looking back on previous treatments
When my grandmother was alive and suffering terribly from RA 30+ years ago, biologic medications did not exist. The few treatments that were available (gold shots, for example), did practically nothing to help her. As a child, I saw her become increasingly crippled and disfigured from the cruel disease that constantly attacked her body. Today, I often wonder what her life might have been like if biologic medications had been around back then.
Trying to hold onto hope
In the face of all of the disappointments and failures concerning my biologic treatments during the past several years, I still try hard to hold onto hope that there is or there will be something out there that will finally work for me again. My ultimate dream and goal is to get off of prednisone and even go into remission for once in my life.
Please, Kevzara, work some much-needed magic! I'm ready.
Has menopause impacted your RA?