How Long Does It Take For Remicade To Start Working – It can be unsettling and scary to start taking medications that you may need to live. For patients diagnosed with rheumatoid arthritis, ankylosing spondylitis, or psoriatic arthritis, the “B” – in biologics – can be especially annoying when talking to your doctor. These drugs are expensive, have a long list of potential side effects, and cannot be taken by mouth.
Biologics used to treat inflammatory arthritis come in two forms: injections, which you give yourself at home, and infusions, which you must receive at your doctor’s office or infusion clinic. These are “major molecule” drugs that have a complex manufacturing process and formulation; they must be given directly into the bloodstream, not by mouth. (Note: There is also a growing class of oral medications called JAK inhibitors that target specific parts of the immune system; these are not technically called biologics.)
How Long Does It Take For Remicade To Start Working
Biological drugs can be a game changer in treating arthritis symptoms and preventing the disease from progressing, which is why they are such an important part of the treatment plan for many people with inflammatory arthritis.
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I am one of them: I have been receiving infusions of infliximab (Remicade) for rheumatoid arthritis for over a year.
When you and your doctor decide it’s time for you to take a biologic drug to treat your arthritis, many factors depend on whether you’re taking the drug by injection or infusion. Some drugs are only available as an injection or an infusion only; some are available in both formulations.
“All medications are effective, so it’s a joint decision between you, your doctor, and your insurance company,” says Vinicius Domingues, MD, a rheumatologist and medical consultant in Daytona Beach, Florida. Your doctor may recommend a specific biologics that he thinks will be best for you. Your health insurance can also affect what biologics you can take. In other cases, your personal preferences may come into play in relation to the following:
For patients who don’t want to inject themselves at home or “go nuts at the needle,” notes Dr. Domingues, IVs are a good option.
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“I didn’t want to risk it,” admits Lindsey Hart, who suffers from ankylosing spondylitis. “It’s been over three years [of the bio infusion] and it has brought me back to life, so I made the right decision.”
Paul Lane, who also has AS, has tried both biological injections and infusions. “I only have to do the infusion once every six weeks and I don’t have to worry about it, but then I have to sit in the hospital most of the day for the infusion. I can inject at home once a week and it only takes a few minutes, but when I go somewhere on vacation or work from home I have to figure out how to take the injection with me and put it in the fridge.”
Both have their advantages and disadvantages; it all comes down to what you prefer and what works best for your lifestyle.
If you and your doctor decide that biological infusions are the way to go, you may have mixed feelings: relief knowing you’ve agreed to a treatment plan, but nervousness about what lies ahead as you continue with your infusion therapy. Visions of needles and IV bags “cause a lot of anxiety,” says Arliz Luna, FNP, who has been giving IVs at Pacific Arthritis Care Center in Los Angeles for 17 years (and, as noted, is my amazing IV nurse).
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The good news is that biologics used in infusions have evolved tremendously over the last few decades. Currently, there are several treatment options that can help stop the progression of the disease, alone or in combination with other disease-modifying drugs such as methotrexate. As scary as it is, it’s important to start treatment as soon as possible after your doctor’s approval.
“These autoimmune diseases are systemic, which means if you have inflammation going through your body all the time, it not only affects your joints, it can affect your organs,” explains Luna. “Long-term effects can lead to heart attacks or lung problems.”
“I was a skeptic for years,” admits Aime Cole, who was diagnosed with ankylosing spondylitis at the age of 27. She went 10 years without biologics even though her rheumatologist wanted her to take them. At first she tried diet, exercise, natural herbs and supplements, but it got worse and worse. “I wish I had listened then and started. It could have spared me a lot of grief.”
It’s normal to be nervous, but the truth is that infusions “are not as bad and scary as they seem,” says Sheila Christman-Schaefer, who has had AS for 10 years.
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As you learn more about the infusion, you’ll probably feel better about continuing your treatment. Here are answers to 12 frequently asked questions by patients about initiating biologic infusions.
Your doctor will discuss with you which biologics is best for your diagnosis. As part of the collaborative decision-making process, you should talk about the pros and cons of each. Biology targets different specific parts of the immune system. Your doctor may believe that one drug is better for you than another because of how it affects your immune system.
It depends on the drug, but it can take anywhere from 15 minutes to eight hours. For example, my Remicade infusion for my RA lasts about three hours; I have to come back every eight weeks. Rafen Norliss Patient with psoriatic arthritis Simponi infusion lasts 30 minutes. This depends on how much you take and your tolerance. The amount of infusion depends on the manufacturer. Some drugs have one standard dose, while others are based on body weight.
When connected to a drip in your hand or arm, the medicine will be ‘administered’ into your body through a vein. You will not feel an immediate change in pain or other symptoms. “These are not painkillers,” explains nurse Luna. “They work with your immune system to reduce inflammation, and with this reduction in inflammation, you’ll hopefully get a reduction in pain.”
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Pain or discomfort is minimal, usually just a stinging sensation when the IV needle is inserted. You will not feel the drug pass through your body. “You shouldn’t smell anything but the drip,” says Sister Luna. “And it’s perfectly normal not to want to see the needle go. Marcey King, who has psoriatic arthritis and received both Remicade and Orencia infusions, recommends hydrating 24 hours before infusion. “It helps to fill up the veins and it will be easier to find a good vein.”
If you are really worried about your bio infusion, tell your doctor or infusion nurse. They may recommend patients with high levels of anxiety to take medication, such as Benadryl, to help them be more relaxed during the procedure. “Once you get through it,” says Sister Luna, “it really isn’t that big of a deal.”
It depends on the drug and your response to it. Some patients may notice an improvement within a few weeks of the first infusion, but it may take several months before the patient feels noticeably better.
“Some patients feel great after the first infusion,” says Luna. “It’s amazing, I won’t argue with that. Just remember not to lose faith if you don’t feel something right away.” Dr Domingues says that if his patients do not feel better after three infusions, he will “reassess what we are doing and consider a different mechanism of action.”
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Mary Lisa Konett, who has ankylosing spondylitis, has had four infusion treatments so far and has already seen a life-changing improvement. “My excruciating iritis [inflammation of the eyes], which causes headaches and sensitivity to light and blurred vision, was not,” she says.
It is often quiet, relaxing and peaceful. Patients can be young, old and of any age. Many infusion centers have soft chairs, blankets, and pillows to make you more comfortable. “I call it my spa day,” jokes Christman-Schaefer. “It’s really nice because I’m sitting in a heated massage chair. I bring a coloring book and they bring me food and drink. I have my own private TV.”
There are no private TVs in my infusion room, but Sister Luna makes sure ours is set to HGTV, which is fun, positive, and neutral. “I asked patients for intense conversations and debates,” he laughs. “So I like to keep TV on a channel without political bias.
Some patients like to sleep, others watch series or movies on a phone or tablet, and still others work on a computer (ask the nurse to put a drip in the arm for maximum mobility). You can bring your loved ones to keep you company or just enjoy a few hours alone.
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Konetta’s best advice for the infusion room is to bring a sweater or hoodie with you as it can be chilly. “I wear wireless headphones to listen to an audiobook because there are already so many wires. And no kidding, the TV is on in my clinic