Biologic Infusion Treatment for RA
Biologic infusion treatment for RA involves a drug that goes directly into your bloodstream via an IV, which involves a needle placed into a vein.
Considering biologic infusion treatment for RA (rheumatoid arthritis) can be worrisome because there is a lot to consider; this includes how to take the drug, the time commitment and potential side effects. It is therefore a good idea to get informed about biologic infusion therapy, so that you can speak with your doctor and make a shared decision.
Most biologic therapies for RA are effective, but ultimately the decision as to whether to take a biologic drug infusion should be shared between you, your doctor and your insurance company.
Your doctor may recommend a biologic he or she thinks will work best for you. Your health insurance company gets involved based on what drugs they are willing to cover and the associated costs.
However, your role is the most important. Here are some things you should consider when making a decision about biologic infusion treatment:
- Your willingness to give yourself an injection versus having a health care provider administer an infusion. If you are someone who cannot give themselves shots or cannot stand the sight of a needle, infusion therapy might be a better option for you.
- How close you live to an infusion center.
- How often you are wiling to take medication. For example, injections are either weekly, every two weeks or once a month. Infusions are given less often — from monthly to once every six months.
- How much time you have to spare: injections take no more than a few minutes to administer in the convenience of your home. For infusion therapy, you will need to go to an infusion center, and you might be there for several hours.
There are pros and cons for both injections and infusions, but for the most part, the decision for infusion therapy ultimately comes down a person’s preferences and what fits into their lifestyle.
During an Infusion
You will need to travel to an infusion location — either your doctor’s office, a hospital or an infusion treatment center. The location will depend on your doctor and/or what your insurance plan requires.
The time it takes for the infusion to be administered varies and depends on the drug. However, you should expect to spend several hours at the infusion location.
Once you arrive for your infusion appointment, you will be hooked to the IV via your hand or arm. There is minimal discomfort involved (only when the needle for the IV is put in).
Once the IV is in, the drug is administered. The drip time will depend on the drug being infused.
Unlike a self-injection drug which deposits the drug directly under the skin, the infusion therapy drug goes directly into the bloodstream. This means that if you are going to have an allergic reaction, it will happen pretty quickly.
The nurses at the infusion location will be close by to identify any issues and respond quickly, should complications arise.
How often you come in for an infusion will depend on the drug. Some are monthly, some are every couple of months, while others are only twice a year.
Infusion Therapy Options for RA
You and your doctor will determine which biologic drug is most appropriate, based on several factors including disease activity, what drugs you have used in the past, your overall health and more.
Some infusion therapies available for RA are:
Remicade is a tumor necrosis factor (TNF)-inhibitor designed to stop inflammation and joint damage. It has been shown to reduce the signs and symptoms of RA, prevent further joint damage, and improve overall physical function.
Remicade can be given as an infusion. It is given about six times a year, and each infusion session takes up to two hours.
Orencia is usually prescribed to adults with moderate to severe RA to reduce the signs and symptoms of RA, potentially prevent further joint and bone damage, and improve overall function.
Infusion treatment with Orcencia is generally every four weeks, and infusions take around a half hour.
Rituxan is prescribed in combination with methotrexate for treating moderate to severe RA. The medication reduces the signs and symptoms of RA and slows down joint and bone damage.
Rituxan infusions are given every six months at an infusion center or your doctor’s office.
ACTEMRA is an interleukin-6 (IL-6) receptor inhibitor, which means it blocks IL-6 (often overproduced in people with RA). Improvements are usually seen within the first few weeks of treatment.
Infusions of ACTEMRA usually take an hour and are given every four weeks.
SIMPONI ARIA® (golimumab)
Simponi is prescribed in combination with methotrexate for adults with moderate to severe RA. It has been shown to relive pain, stiffness and swelling, stop further joint damage, and improve daily function.
Infusion therapy with Simponi starts with two starter doses, four weeks apart, and after that infusions are once every four weeks. Infusions last about a half hour.
Side Effects/Risks of RA Infusion Treatment
During an infusion treatment for RA, the nurses will watch for allergic reactions including flushing, itching and hives. Skin reactions are a common side effect of infusion therapy, so you will be monitored and medication to alleviate any reaction will be given immediately.
Other side effects of infusion therapy are:
- Low or high blood pressure
- Chest pain
- Difficulty breathing
Report any immediate side effects to your doctor or the person administering the infusion treatment. You should also call your doctor if you have any serious side effects after you have left the infusion center.
All biologics — whether taken by infusion or injection — carry a long list of side effects. Some of these may be serious, because these medications affect the way the immune system works. You can also learn more about the side effects of RA medications here.
Common side effects of biologic therapy are nausea, abdominal pain and headache. More serious, but less common side effects are shortness of breath and chest pain.
When on biologic therapy, you should watch out for infections — from the common cold and the flu to serious infections, such as pneumonia and fungal infections. In the long term, these drugs may increase the risk of certain cancers, although this is rare.
Each biologic drug has its own set of side effects, so make sure you discuss these with your doctor and bring up anything that concerns you. While side effects are concerning, you should keep in mind that your doctor has prescribed biologic infusion therapy because he or she feels the benefits outweigh the side effects of the drug.