Hi Mary - when I asked my rheumy for when improvement should start kicking in, he was vague, but said that there's no loading dose and I should gradually feel better from the first infusion. Also, I notice that if I go more than a month between infusions, I flare increasingly worse as the weeks go on, to the point that my hands and feet are swollen and can't be controlled even with a Medrol dose pack. So - bottom line, it seems like you should have experienced more improvement by now.

Do you know why your rheumy recommended Actemra? Had you failed other biologics before moving to Actemra? I'm on Actemra because I overproduce IL-6 proteins, which is what Actemra is designed to control. If you don't have too much IL-6 (and most people with RA don't - they overproduce TNF instead), Actemra may not be the most effective choice for you.

Trinaunz ~ Unfortunately, I've failed 3 TNF inhibitors (Enbrel, Humira, and Simponi) so we are going this route now. My rheumy did mention that we could increase the dose if we need to. Guess I'll try that next. Thanks for the info!

@Mary - got it. I too started at a lower dose of Actemra and now I'm at the maximum dosage. I suppose Remicade, Arava and Orencia might be alternatives for you if Actemra doesn't produce improvement at a higher dose or with a few more months.

FYI, I was prescribed Actemra after finding out what proteins I over-produce through the Vectra DA test. You may want to ask your rheumy if that would be a recommended test for you. Insurance covered part of mine and the maker (Crescendo Bioscience) waived the rest of the fee down so my out-of-pocket cost was $95. I'm so glad I took that test as I would have needed to fail at least 2 more meds before trying Actemra. Here's the website for more information about the Vectra test: http://www.vectrada.com/

Good luck with your treatment!

I haven't tried Actemra. I have taken Remicade and wound up with liver damage after five years. Enbrel and Humera didn't help.. Rituxin is next on my dance card.

@trinaunz - Thanks for the information. I see my rheumy for a "routine" visit in two weeks. I will ask her about this particular test! We discussed Remicade but unfortunately, it's a TNF inhibitor too and since I've already failed three of them didn't want to try a fourth.

@lycesq - So sorry to hear about your liver issues. I'm just now 3 years into this journey. Have only had one transient bump in my liver enzymes but had to reduce mtx and my joints were not happy! Thanks for the info

I found that the Actemra did help 20-30% but that was it. My inflammation dropped to 1 which was good but I was still in quite a bit of pain. It was not enough relief to get me off of the Pred., so I had to stop it. I noticed the different after about 5 months. I was told Actemra does not require MTX to enable it to work properly. MTX doesn't help me much anymore anyways. I'm not on it now.

I've been on Actemra for about 6 months now. My inflammatory markers are back in the normal range - or at least they were. Since I hit "normal" a few months ago, I've been slowly tapering off prednisone. Actemra has given me no pain relief. I am less mobile now than I was 6 months ago. When I switched from Enbrel to Actemra, I also quadrupled my pred dose. I'm afraid that the pred was what got my inflammation down. I don't see my rheumy until the end of June, but I think I need to get my blood drawn and bump up my appointment.
My first few infusions were at a lower dosage. I had no improvement, so they doubled my dosage. Are you at the higher dose yet?

@eemonkey ~ No still at lower dose. I've only had 2 infusions with the third one in about 10 days. I also see my rheumy at that time and plan to ask her if/when we go to a higher dose. Thanks for your input!

Just adding my experience - I've been lucky with Actemra so far, markers dropped to normal literally overnight and felt around 75% better after the first week. By 3-6mo I was 95% normal, which is where I remain a year down the track. I don't take anything else at all (failed MTX due to side effects, react to pred & anti-inflammatories so don't like taking them). I have minimal side effects on the Actemra - a little tired on infusion day but back to running the very next day. I have around 3 days every two months where I feel like wretching all day, but it always goes in a day or two. No Vectra test in Oz, was put straight onto Actemra due to high demyelination risk with tnfs. Long may it last! I hope you get some progress with your treatment soon, RA is a horrible thing to be dealing with x