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Biologics ? When is enough, enough?

Hello everyone, hope all is well. I am currently on a treatment vacation. I developed Pityriasis Linchnoids on Orencia. I have , in the past year, gone threw four DMARD's and two Biologics. The next drug I am considering is Actemra. My concern is two fold. One, I have mild diverticulitis and cardiac issues. I have discontinued all pain meds as well. The problem is it is reeking havoc on my BP and heart rate. I also have been off drugs long enough to realize I feel much better. There are so many side effects I could no longer tell if problem was meds or disease. Now I am not so sure I want to go back on Biologic. There is no cure and clearly remission is unlikely. My inflammation is under control. Not sure how. Should I just put things on hold?

4 Replies

Just tell them that you feel you need a break.I have tried 3 dmards and 3 biologics and after third developed an other bad health issue so now on warfarin for life and won't be offered another biologic.I don't want one anyway .It's your body n your health.just keep the option open


I'm no doctor, but having all those drugs in the last year sounds dreadful for wonder you are feeling so down!

I can only speak from my own Rheumy of 10 years always says " try this for 3 months" & if that drug he prescribes doesn't start to help he either stops it or changes the dose.....but he doesn't put me in another & another & another within a year.

As you feel things are under control now maybe you could get a second opinion from another rheumatologist?

I do hope you find a doctor who can help you very soon.



For me DMARD's cause problems but generally biologics are OK and it is possible to take them without having DMARD's although they do appear to work best if taken in conjunction with a DMARD. There is no right or wrong answer here and you have to go with how you feel. Hopefully your team are willing to discuss things with you and go forward and react as necessary depending on how the disease progresses. Would introducing one drug at a time enable you to eliminate those that cause you problems? Farm


Now starting week two drug free. It is very challenging but necessary. I need to regain some level of control. I have seven doctors precribing at the same time. I weigh 101 pds . I am carefully monitoring BP and heart rate. I am finally starting to feel a little better. Now it will be even harder to talk myself into another Biologic. I simply need to stay strong. The pain meds, opiates, never worked anyway. I motabilize them very quickly. I had genetics done so that I could avoid drug reaction. However, Actemra has only been on the market five years. There is no information re long term effects or pharmacogenetics.


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