Rheumatoid arthritis (RA) is a joint condition that can be painful and debilitating. While it can be treated using oral medications, rheumatoid arthritis sometimes requires more aggressive treatment using infusion therapy. These intravenous treatments can offer stronger and more lasting relief than oral treatments.
What is Rheumatoid Arthritis (RA)?
Rheumatoid arthritis is an inflammatory disease affecting joints.
This condition is caused by the immune system attacking your own joint tissues and causes inflammation, pressure, and pain. This makes moving more difficult and uncomfortable, making even simple tasks painful and daunting.
RA symptoms often come and go in a cycle of flares and remissions.
The condition is, however, chronic and requires long-term treatment.
More conservative treatments will work solely on reducing inflammation and pain, while more advanced treatments focus on suppressing the overactive immune system.
Why Use Infusions for RA?
While oral medications can control rheumatoid arthritis for some people, others find it very difficult to manage their symptoms.
Infusions involve using more powerful medication than are taken by mouth and have the advantage of entering directly into the bloodstream.
Oral medications have to be broken down, absorbed through the intestines, and processed by the liver before entering the bloodstream.
This limits the types of medications that can be used orally.
Medicine given directly into the veins can be more molecularly complex, as they will not be broken down during digestion or processed by the liver before reaching circulation.
Injection vs Infusion
Injections typically refer to medications that are injected into muscle, fat, or other tissue. Some rheumatoid arthritis may be injected instead of given as an infusion.
Injected medications can be more molecularly complicated than oral medications that get broken down during digestion, but the most advanced medications cannot be injected.
This is because these advanced medicines may either break down as they pass through tissues as they are absorbed or because they could cause irritation at the injection site.
Infusions are different from injections and are given directly into the veins instead of being injected into muscles. For most infusions, a small tube called an IV catheter will be placed into a vein.
The medicine is given through this tube and enters directly into circulation.
Infusions can contain very molecular complex medications, as they enter into the bloodstream without the body having to absorb or process them.
While infusions are the most effective way to deliver a medicine, they must be used carefully, as there is greater risks of complications when injecting something directly into the body’s circulation.
Medicines Used in RA Infusion Treatments
The exact medication used for rheumatoid arthritis will need to be determined by a doctor who is familiar with your unique situation.
While RA infusion medicines work in many different ways, the primary end result is that they suppress your overactive immune system, treating the underlying cause of RA.
Medicines used in RA infusions are almost always antibodies that are either made artificially or modified from existing antibodies.
Antibodies bind to very specific proteins, allowing them to precisely target specific molecules.
Rituximab (Rituxan)
Rituximab is a monoclonal antibody. This medicine is designed to reduce the number of certain types of immune cells. While sometimes used for cancers that affect immune system cells, this medicine also is used in RA to reduce the number of immune cells that attack joint tissues and cause RA symptoms.
Infliximab (Remicade)
Infliximab is another type of monoclonal antibody and works by blocking certain signals used by the immune system to cause inflammation. This helps to inhibit how immune system cells respond, keeping them from attacking joint tissue and causing RA symptoms.
Abatacept (Orencia)
Abatacept is a modified antibody and works by blocking how immune cells communicate with each other. This keeps the immune system from mounting large-scale immune responses to joint tissues and helps to prevent RA flares, and lowers the inflammation and pain that RA causes.
Tocilizumab (Actemra)
Tocilizumab is a monoclonal antibody that binds to a protein that plays an important role in the inflammatory response, keeping it from transmitting signals to immune cells. This ultimately reduces the immune system’s inflammatory response to tissues in the joint and suppresses the inflammation and pain of RA.
Golimumab (Simponi Aria)
Golimumab is a monoclonal antibody that works in a similar way to infliximab. This medicine blocks signals from specific molecules that promote inflammation and activation of the immune system. This results in decreased inflammation and joint pain in those who have RA.
What to Expect During an Infusion
Before getting an RA infusion treatment, you will meet with one of our professionally trained rheumatologists who will determine what type of medication will best benefit you.
They may perform additional tests and will carefully review your medical history to choose the safest and most effective medicine.
During the infusion itself, you will have an IV catheter inserted into a vein.
A needle is used to place this small tube but is taken out as soon as the IV is placed, and only a small, flexible tube will remain in your vein.
The infusion will typically come in a bag that is attached to your IV site using clear tubing.
The tubing will go through an IV pump that controls how quickly the infusion is going.
You may not feel anything during the infusion or you may feel some coolness at the IV site as the room temperature infusion enters your body.
Before, during, and after the infusion, you will likely have your vital signs taken to monitor how you are responding. If it is your first time getting particular medicine, you may be monitored more closely than you will be for subsequent treatments.
RA Infusion Side Effects
Any medicine can create side effects and RA infusions are not an exception to this. While there are many rare side effects that can happen, the most common RA infusion side effects include:
- Headaches
- Redness or hives if an allergy to the medicine occurs
- Pain or swelling at the infusion site
- Nausea
- Fatigue
Each RA medication is different and can have varying effects based on the individual.
You should ask your doctor about your specific risk of side effects before getting your first infusion.
The clinicians monitoring you during your infusion should quickly recognize and treat any side effects that do begin to develop.
How to Get an RA Infusion
The best way to get an RA infusion is to visit a rheumatologist.
These doctors specialize in treating joint diseases like RA and are the top experts in the medical field on how different RA medicines work. A rheumatologist can help you determine if an RA infusion is right for you and organize for you to get one.
Southwest Florida Rheumatology provides some of the highest quality rheumatology services available in Florida.
Contact us today to learn how we can help you get lasting relief from joint pain.