So why biologics if joint disease still persists?

By barin

1 min read

I'm 67... I was diagnosed at 53 with seronegative RA... By then, I already had 1 knee replacement... Now I can say I have had 9 including the knuckles in both hands.

Joint damage while on biologics

I have been on many of the biologics, and the most recent, Xeljanz and Actemra, helped tremendously with the symptoms, so I was hopeful that my joint replacement days were over.. Low and behold, I just learned that in 4 years, my other knee has deteriorated and will eventually need to be replaced. So why continue on these toxic medications if they do nothing to halt this deterioration? I am at a crossroads...

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Richard Faust Community Admin
Hi barin. Your frustration is certainly understandable. Every case and individual is different, so I can't speak to your specific situation, but I do have a few thoughts on RA treatment and deterioration that may help a little. First, I want to tell you a little about my wife, Kelly Mack (a contributor here). Kelly was diagnosed at two, had both knees and hips replaced as a teenager, has used a wheel chair since her late teens, and has now had juvenile RA for over 40 years. One of the conversations we have had with her rheumatologist a few times is that nothing can undo the damage that has been done (the hope is that kids today, with modern treatments, won't have the same level of damage). He has also pointed out that basically everyone with RA will also experience osteoarthritis wear and tear. I'm relaying all this to raise the possibility that some of your knee damage may have existed prior to finding treatments that really seemed to help (not that some RA damage couldn't still occur) and been exacerbated by age/time related osteoarthritis. Of course, only a doctor can properly determine the diagnostics of your individual case, but it may be worth a conversation with the doctor on what may have contributed to your knee issues. Each individual needs to determine for themselves what level of side effects and risk are acceptable relative to the benefits of a given treatment. Our contributor Michael wrote about this balancing here in what he calls the "Risk to Risk Ratio:" <a href='https://rheumatoidarthritis.net/living/the-risk-to-risk-ratio' target='_blank'>https://rheumatoidarthritis.net/living/the-risk-to-risk-ratio/</a>. As a side note: about two years ago Kelly started a treatment that brought her inflammation levels down into the normal range for a sustained time for the first time ever. One never knows when the lightening on finding that treatment might strike. Wishing you the best and please feel free, if you like, to keep us posted on how you are doing. Richard (RheumatoidArthritis.net Team)
L rick Phillips Moderator & Contributor
barin: I am sorry this is happening. I hope you understand that not all biologic work for each person. I have been on five of these and two of those have worked well. My first and last. In fact that is more the rule than the exception. My best advice is to keep working it, keep positive, do the things you need to do be successful. Exercise, follow the doctors instructions, and keep making sure that you remain positive. Almost everyone who does those things is ultimately successful. Oh and stay with us, this is a great community, we are glad you joined us.