Infusion therapy for rheumatoid arthritis (RA) can be an effective treatment option for people who do not respond to other medications.
A person living with RA may want to discuss infusions with their doctor if they find their symptoms do not improve with other therapies or are getting worse.
Infusions involve a doctor inserting a medication known as biologics into the bloodstream. The medication helps to suppress the immune system and reduce inflammation.
This article will explore:
- what infusion therapy is
- the different types of infusion therapy
- the pros and cons of receiving infusion therapy
- what to expect during the procedure
- side effects
Infusion therapy is a type of prescription therapy for RA that uses biologics to help alter how the immune system functions. A person may use the therapy on its own or as part of a combination of therapies with oral medications.
Biologics are a form of medication made up of living organisms and cells. Biologics can target parts of the immune system to prevent inflammation that associates with RA and other inflammatory disorders.
However, unlike other medications, doctors need to administer biologics directly to the blood, either through an injection or infusion.
Infusion therapy uses an intravenous (IV) line to slowly administer the medication over the course of a few minutes up to about 8 hours.
Biologics through infusion have several potential benefits, but they also have a high chance of reactions and side effects. Some potential pros and cons include:
- medical professionals administer infusions
- biologics often provide an effective treatment for RA
- the time between infusions is typically longer than other treatments, with about 1 to 6 months between sessions
- biologics can have several side effects
- infusions can take several hours
- a person needs to travel to a hospital or other injection center
- infusions are expensive and may not get insurance approval
Infusions differ in the medication they administer to the person. Each biologic targets a specific part of the immune system, so a doctor will recommend a biologic according to what they believe is most likely to work for the person.
Some common types of medications that doctors use in infusions include:
- rituximab — targets B cells
- tocilizumab — blocks the immune system protein interleukin-6 (IL-6)
- infliximab and golimumab — block the immune system protein tumor necrosis factor
- abatacept — blocks signals between T cells in the immune system
Biologic infusions for RA are expensive. A person’s insurance may not cover all types of infusions, and what it is willing to pay may dictate which medications they receive.
The price of infusions can vary between the different medication types. According to a
- rituximab — $36,663
- tocilizumab — $36,821
- infliximab — $44,973
- abatacept — $46,532
A person will need to work with their doctor to determine the best medication for their needs. Once they decide on a biologic infusion, they will schedule a time for a person to receive the infusion.
At the infusion site, a nurse or tech will prepare the person by inserting an IV line into their arm or hand. Once the doctor has set the IV line, they will start a drip and usually give premedications such as acetaminophen and antihistamines to reduce the risk of infusion reactions.
Then they will administer the medication that will enter the bloodstream.
The process can take anywhere from about 15 minutes to 8 hours.
The infusions do not typically hurt nor provide instant pain relief. However, a person may feel a pinch when the IV line inserts.
During the infusion, a person can relax in the infusion room. A person can read, watch TV, sleep, or do other leisure activities while they receive the infusion.
Following the infusion, a person can typically go home the same day. A nurse or other staff may monitor them for signs of allergic reaction before sending them home.
A person may experience fatigue that seems strongest in the first day or two after infusion, but that gradually improves.
A person should talk with a doctor about any specific instructions prior to the infusion. They can provide details on what medications to skip, if any, and any other special instructions based on the person.
Some recommendations prior to an infusion that may help a person prepare include:
- learning more about the infusion and possible side effects in order for them to be as informed as possible
- asking as many questions as necessary of their healthcare team
- bringing comfortable clothing, blankets, books, music, and other items that may help the person stay comfortable
- keeping a positive mindset about the potential success of their infusion
Biologics can be an effective form of treatment for RA, but they can lead to some side effects.
The infusion process itself is generally safe. A person may feel a slight pinch when the doctor inserts the IV line into their vein. Their nurse will also monitor them for an allergic reaction to the infusion.
Some common side effects that research associates with biologics include:
- increased risk of infection, particularly upper respiratory infections
Infusions for RA provide a form of medication known as biologics. These target the immune system and prevent inflammation that causes RA symptoms.
Infusions can provide effective therapy, but they have some drawbacks such as side effects, cost, and a need to go to a clinic or hospital to get them.
A person should work with their doctor and insurance company to determine the best medication for their individual needs.