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I was supposed to have my latest Actemra infusion in a few days. I say “supposed to” because as we all know, plans tend to change when you have RA.

I first started on Actemra injections the middle of last year and switched to infusions about a year ago. In January, we maxed out the infusion dosage and added methotrexate to the mix and, for the first time for some time, I felt like something was finally working (again).

Like everyone, I love it when a treatment makes me feel better. But unlike most people, my system tends to build up a resistance to the treatment over time and it quits being effective. This has now happened to Actemra as it has eight other drugs before it.

I moved up my rheumatologist’s appointment to before the infusion because I couldn’t see undergoing that expensive treatment if it wasn’t going to help. I guess the good news (perhaps bad news?) was that my joints were visibly swollen and tender when I went in for my appointment yesterday. I hate it when I go in whining and both my joints and my labs look perfect.

I took my list of past drugs in with me to discuss. About the only thing not on the list is Rituxan, an infused biologic and my rheumatologist has been hesitant to recommend this for me. We talked through those reasons which I understood. And then we talked about Simponi Aria, which is the infused version of the injectable biologic, Simponi.

I had been on injectable Simponi in 2009, shortly after it had been introduced and I did well on it. However, the effects didn’t last the entire time between injections, so we moved on to the next drug. Since then Simponi Aria has been introduced giving additional treatment plan options. The plan is to keep me on the injected methotrexate and oral meloxicam as well. While we’re waiting for the insurance approval for Simponi Aria to percolate through, I’ll do a low dose of prednisone to help keep things calm.

I’m excited for the change because what we were doing wasn’t working. The only fly in the ointment is that I’ve “failed” on every other TNF-inhibitor I’ve been on (and I’ve been on all of them). There is discussion in the medical community and some evidence to indicate that failing on a TNF is an indicator that subsequent TNF inhibitors will also fail. That being said, every biologic drug is different. There are even differences within the same class of drug. Of all the drugs I’ve been on, I liked Simponi the most, so I am hopeful that Simponi Aria will work well for me this time.

If for some reason it doesn’t, I still have a rheumatologist that listens to me and is committed to my care, which is a major blessing in itself.

So those are the changes brewing in my life. I hope whatever changes that are in store for you bring health and happiness to you and yours. Thanks for checking in.