IV Infusion Therapy for Severe RA: Your Questions, Answered

More than 1.5 million people are living with rheumatoid arthritis (RA), and managing it effectively requires a comprehensive treatment plan. At Comprehensive Arthritis Care in Hendersonville, Tennessee, IV infusion therapy is part of a personalized treatment approach meant to stop RA from controlling your life. 

Under the guidance of board-certified rheumatologist Mohammad F. Ali, MD, patients with advanced RA receive carefully tailored treatment using the latest in biologic medications and other cutting-edge therapies, and a level of care that’s rooted in experience, comfort, and compassion.

If you have severe RA, and are considering infusion therapy, here’s what you need to know.

How RA becomes severe

RA is a chronic autoimmune disease in which immune cells attack the joint lining (synovium), resulting in stiffness, discomfort, and edema. It frequently affects the hands, wrists, fingers, knees, feet, ankles, and toes, and if not treated, the cartilage in those joints erodes. There are four RA stages:

• Stage 1: no joint damage
• Stage 2: inflammation and cartilage damage
• Stage 3: severe inflamed bone damage, increased stiffness
• Stage 4: inflammation stops but damage continues

The issues associated with RA tend to worsen the longer it goes untreated, making therapy more challenging in later stages. Complications may include bone density loss, anemia, carpal tunnel syndrome, heart and lung disease, various autoimmune issues, pneumonia, kidney failure, vasculitis, lymphoma, and amyloidosis.

What is IV infusion therapy for severe RA?

Patients with severe rheumatoid arthritis often receive intravenous (IV) infusions of biologic drugs that target particular immune system components to reduce inflammation and prevent additional joint destruction.  The primary IV infusion drugs utilized are:

Abatacept (Orencia®)

Blocks T-cell activation, which reduces inflammation. It’s administered initially every two weeks, followed by monthly, with each infusion lasting about 30 minutes. 

Infliximab (Remicade®)

A tumor necrosis factor (TNF) inhibitor that prevents TNF, a protein that causes inflammation.  Infusions are given three times in six weeks at first, then once every eight weeks. Each infusion can take from 2 to 4 hours. 

Rituximab (Rituxan®)

Targets B cells that contribute to RA inflammation. It’s often administered as two infusions two weeks apart.

Tocilizumab (Actemra®)

Blocks interleukin-6 (IL-6), an inflammatory protein. Given once every four weeks via infusion lasting about an hour. Improvements may be noticed within weeks to a couple of months.

Each medication is selected based on your unique symptoms, disease progression, and treatment history.

Who qualifies for infusion therapy?

Infusion therapy is typically recommended when other treatments haven’t been effective or well-tolerated. If you’ve already tried methotrexate, corticosteroids, or other oral DMARDs with limited success, or you’ve experienced severe side effects, infusion therapy may be the next step.

The clinical staff at Comprehensive Arthritis Care reviews your medical history, lab results, and imaging studies to determine if infusion therapy is right for you. The goal is to slow or even halt joint damage and keep you as mobile and independent as possible.

What can I expect during treatment?

Infusion sessions are performed in-office in a dedicated, comfortable infusion suite. You’ll sit in a recliner with free Wi-Fi, snacks, and a peaceful environment while the medication is administered. 

Many patients feel improvement within days or weeks, while others may need a few treatment cycles before noticing significant changes. Your infusion schedule is determined by your rheumatologist.

Taking control of your RA starts here

With the right treatment, you can stay ahead of the disease instead of playing catch-up. Contact us at Comprehensive Arthritis Care today to find out if IV infusion therapy is right for you.