Biologic response?

I have been reading and learning a lot from you all for a while—thank you. I was diagnosed sero-negative in September 2020 after a rapid onset of hand, wrist and knee stiffness and swelling. Plus a fair dollop of fatigue, generally feeling ‘ill’. I have escalated through to 25 methotrexate plus hydroxychloroquine and still uncontrolled on 10mg oral Prednisolone, so I started Adalimumab/Amgevita at the start of February. The 2nd dose caused or coincided with quite an increase in symptoms, but 3rd dose has been OK but definitely still have morning stiffness and swelling and of course I’m aware that the Prednisolone is still controlling some of that. I guess I wonder whether to expect all the symptoms to go away or is that too much to expect? And whether to expect more improvement on this? How quick did you know a biologic was working for you?

Thanks very much!

[charisma]

Hi MrsSBJ

You’ve probably gathered that each of us may respond differently to any RD drug prescribed.

I went the Sulphasalazine route first (prescribed by locum Rheumy) but within a month was immediately taken off it due to severe infection and reaction; three weeks to recover.

Then it was a steroid taper with Methotrexate and Hydroxychloroquine. Those were at high doses and did a fairly good job after four months.

Then my body began to reduce its tolerance of the drug so after two years we tried Leflunomide. That worked a treat to for the first four months.

So then it Amgevita which did not work for me.

Then it was Rituximab which can take four to six months to kick in; low dose steroid tapers kept me going for another nine months till the second round of infusions of Rituximab began to make a difference.

Just had third round and find little pain and stiffness but the feeling of being up to 90% more like my pre RA self is not back yet.

So, for some of us, it can be a long path to long term remission. Yet others may find drug induced remission is achieved long term from early months of drug therapy beginning.

Insufficient response to a drug after the expected first three months indicates it is failing you and it’s time to try something else. Don’t suffer longer than you have to! x💐

[helixhelix]

My biologic took 12 weeks to start to kick in. We were just about to give up on it!