What is the best infusion for rheumatoid arthritis
Learn the four most effective DMARDs for rheumatoid arthritis infusion therapy here.

Disease-modifying antirheumatic drugs (DMARDs) are widely regarded as the most effective infusion therapy for rheumatoid arthritis. To reduce inflammation, DMARDs target special proteins in your body or inflammatory chemicals that your body produces on a cellular level. 

For the treatment of RA, there are four biologic DMARDs that are administered through infusion. Each of these medications works by targeting a different part of the immune system, but they all have the same goal—to reduce inflammation and prevent joint damage while slowing disease progression.

4 DMARDs for rheumatoid arthritis infusion therapy

Rituxan (rituximab)

  • It belongs to a class of biologics that targets specialized immune cells known as B cells. In RA, B cells produce auto-antibodies that target and damage the healthy cells and tissues. Rituxan acts by preventing B cells from producing auto-antibodies.
  • Rituxan is usually administered in two infusions, two weeks apart, for the initial course. To avoid undesired side effects, corticosteroids are administered through an intravenous route about 30 minutes before each Rituxan infusion.
  • Infusions of Rituxan take three to four hours. However, you won't see any changes for at least three months after treatment.
  • Once treatment begins to work, the benefits can last for 6 to 12 months or longer. Rheumatologists may recommend that treatments must be repeated every six months.

Actemra (tocilizumab)

  • This biologic drug inhibits the binding of inflammatory proteins known as cytokines to immune cells that prevent the immune cells from becoming activated, lowering inflammation levels.
  • Actemra can be used as a single agent or in combination with other DMARDs.
  • It takes about an hour to complete the infusion. When compared with other infused biologics, it typically takes four to eight weeks to notice the drug's effects.
  • If a lower initial dose is ineffective, the dose can be increased. Moreover, it is available as a subcutaneous (SQ) injection.

Orencia (abatacept)

  • This biologic drug inhibits a type of immune cell interaction known as co-stimulation. Blocking co-stimulation prevents cells from activating and thus stops inflammation at its source.
  • Orencia is administered through intravenous infusion or SQ injection. First doses are administered at baseline, two weeks, and four weeks.
  • After the initial course, doses are usually given weekly for SQ administrations or once a month for intravenous administrations. Infusions last 30 to 60 minutes each time.
  • You may notice improvements within three months, and they may last for the entire first year of treatment.

Remicade (infliximab)

  • This medication is one of several biologics that target the inflammatory protein tumor necrosis factor-alpha (TNFA), which is the cause of inflammation and bone erosion in RA and is found in high concentrations in the joints of people with the condition.
  • Remicade works by binding directly to TNFA, preventing it from interacting with inflammatory immune cells.
  • Remicade is administered through intravenous infusion, with doses initially administered every 15 days.
  • Following the completion of this initial course, infusions may be administered every eight weeks for maintenance.
  • Infusions last between two and four hours on average. Remicade is frequently used in conjunction with another DMARD—methotrexate.

What are the possible side effects of infusion therapy in RA?

This treatment is not appropriate for all people with rheumatoid arthritis (RA). Although side effects are rarely severe, some people report a drop in blood pressure because of their treatments. If you are taking blood pressure medication, your doctor may advise you to stop taking it before your first intravenous infusion therapy appointment.

In most cases, side effects of this treatment subside within the first 24 hours, but they may include:

If you've been diagnosed with RA and haven't seen any improvement with standard treatments, intravenous infusion therapy may be a good option. Doctors will decide if you are a good candidate for this treatment.

How effective is infusion therapy for RA?

Rheumatologists may prescribe infusion therapy for arthritis treatment to people for various reasons including symptom alleviation. When opposed to oral drugs, many people like not having to take medication regularly and find the infusions to be a better experience. 

Many people prefer infusion therapy to regular oral drugs because of the advantages it provides. These advantages include, but are not limited to, the following:

  • Decreased swelling
  • Improved range of motion
  • Increased energy
  • Joint damage prevention
  • Reduced aches and pains

Infusion therapy for people with RA can provide relief from symptoms for anywhere from six months to a year. The length of each infusion session is determined by the severity of the illness and the type of medication used.

QUESTION

The term arthritis refers to stiffness in the joints. See Answer

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Medically Reviewed on 9/21/2021
References
Infusion Treatments for Rheumatoid Arthritis: https://www.webmd.com/rheumatoid-arthritis/infusion-treatments-rheumatoid-arthritis

DMARDS: https://www.arthritis.org/drug-guide/dmards/dmards

Diagnosis and Management of Rheumatoid Arthritis: https://www.aafp.org/afp/2011/1201/p1245.html