Hi Cory, I am sorry to hear that your husband is having such a hard time. I have never heard of a doctor waiting until someone was in remission before starting a biologic. Because a biologic is a very strong med that stops or slows down your immune system from attacking your body. If someone was in remission then they wouldn't need the biologic med. The doctors usually go by your blood tests if you are positive for RA or by the damage they might see in your body through xray, mri or just looking at your joints. I do know one thing that is for sure and that is my husband sounds just like yours he really doesn't like going to doctors. I think if I was your husband I would chat with the doctor again about a biologic just to make sure he heard the doctor right. Most doctors will give the meds time to work....some do take some time to start working maybe a few months or so but if he is on the meds you listed and it has been a few months or so I would talk to the doctor again. Sometimes our insurance is a problem too we have to try this med before going to a stronger med. Remission for some it can happen and for others they might never see a remission. I hope your husband can get this figured out so that he can get to feeling better soon. I have read on here where some folks have decided to get a 2nd opinion if they didn't get the help they needed from their doctor.

I'm not sure if I Reply here if it keeps the conversation going. Here goes, Tilly65 mentioned the RA Factor Number ? My husbands was 116 iu/ml and his ccp antibody was 225 we were told that because both numbers were relatively high it would indicate a rapidly progressive severe form. He has severe joint damage already. What is the methotrexate used for? I felt confident in his rheumatologist and what he said but everyone here talks about the biologic? I'm going to call tomorrow to make a earlier appointment. Bobbarstow mentioned the DMARDS??? I'm not familiar with the terms yet. Thank you both for taking time to answer ... I appreciate the knowledge and willingness to share.

DMARDs (disease-modifying anti-rheumatic drugs) are usually the first medications given, often methotrexate or plaquenil. They are cheap, usually reasonably well tolerated, and somewhat effective at slowing disease progression. Almost everyone begins treatment with one.

Insurance companies usually require a trial of DMARDs before approving a biologic. These drugs (Enbrel, Humira, Remicade, Orencia, etc. [generally monoclonal antibodies if you're a science geek]) can be extremely effective, but they cost thousands of $$ per month. No, that's not a typo. When I first started treatment, it was like my rheumy was watching the clock, ready to file a preauthorization request for a biologic the second I hit six months on methotrexate.

Please ask any and all questions. As you have figured out, this site was just massively revamped and it's making everyone crazy. Even so, there is a lot of knowledge, kindness, and willingness to help around here. It's just harder to tap into with the new format. I guess no one ever told them, "Don't fix it if it ain"t broke!"

Definitely push for a biologic. They are the latest drugs to treat RA, and they have been around quite a few years now. Biologics are actually some kind of live bacteria, different kinds for different biologics. Some are given in infusions, in a clinic or hospital. Some are self injected needles. I've done both, I prefer needles over scheduling appointments, driving a long way, sitting in a chair for 6-8 hours tied to an IV. BUT, some infusions, like Rituxan can put you into remission for 6 months or a year. So if it works, it is a good option.

I've been on a lot of biologics, I just wish there were more and stronger ones. As for your strong husband, you need to be very aggressive with him and the doctor. He is not really living. If he gets on a biologic, he well could become the strong man who doesn't need a wheelchair at the airport, and can carry your bag.

Because biologics are the closest we have to a cure! You do need to keep taking them, but I know many here will agree that they have given us a portion of our life, minus the deformities we got not being treated early enough with them, back in the old days.

So, once again, find a rheumatologist who will treat him as he is. I have been on 7 biologics, and all of them were started when I was at my worst. And some of them helped me get MUCH better. Plus, the longer you wait, the worse RA can become. Tell your husband that I said it is great to inject the products of mouse poop into yourself, because the pain stops, the deformities stop, and you get your life back. (Kineret - mouse poop!) LOL

Oh yes, and different biologics attack different parts of the immunes system. Kineret attacks Interleukin 1. Actemra Interleukin 6. Rituxan - B cells. Enbrel and Simponi- TNF blocker, Xeljanz some kind of jaknase somethings, Orencia - T cells! And so on!

RA attacks the body. It is the body's own immune system that is attacking the body. So treatment is now aimed at shutting down parts of the immune system, so the body does not attack itself. It sounds radical, but it really works, and it literally saves lives.

That is about all I know. Do some research on-line, and get that man to a doctor that will treat him now! Hugs!

Hey, Cory......you are doing just fine both in being concerned about you husband and in using this site. I was diagnosed 2 years ago and most of what I learned is from the good folks here. Myself, and almost everybody starts with the Methotrexate and many do very well on it but all of these things work on their own schedule. even after the meth didn't work for me ,I was started on a biologic and had mtx added to it. The Enbrel I take is $3,000 per month but between BCBS and Enbrel I pay just a $10 co-pay. It really seems that the doctors really don't know what will work for you so they use the insurance protocols and give you the next one in line until something works. Keep asking questions........speaking as a 60 year old male I'd be grateful if my spouse was trying to learn all she can about this disease. Good Luck

Humira is one of many biologics. They are best medications for RA. I think you may have misunderstood his doctor. I doubt he is waiting for remission to start a biologic - he is likely just waiting for a flare up to calm down. Start reading at the Arthritis Foundation website.

Warriorgal, Yes I must have misunderstood. It was so much information to take in. He is in the middle of a never ending flare.. The methotrexate and prednisone have helped take the heat away but he is extememly swollen. Marlenej, Thank you for your obvious knowledge of the different biologics. I take a little bit from each and everyone here and I feel I am better prepared for his next appointment.

Cory, Here is an excellent article on the major biologic medications. It will give you an idea of what each one is, how it is given, effectiveness, adverse effects and costs. This may help you and your husband feel a little more informed when you visit with his doctor. http://consumerhealthchoices.org/wp-content/uploads/2012/08/BBD-RheumatoidArthritis-Full.pdf