Rheumatoid Arthritis

FDA Approved RA Therapies

Cimzia® (certolizumab)

Description

Cimzia® decreases inflammation in the body by binding to and blocking a protein called tumor necrosis factor alpha. It is FDA approved for the treatment of rheumatoid arthritis in adult patients with moderate to severe active disease.

Dosing and Administration

Cimzia® can be self-administered subcutaneously. The recommended dose is 200 mg initially for two injections, followed by 200 mg every other week or 400 mg every 4 weeks.

Common Side Effects

The most common side effects of tumor necrosis factor inhibitors include infusion or injection site reactions, upper respiratory infections, and allergic reactions. There is also a slight risk of more serious side effects including lymphoma and serious infections.

Enbrel® (etanercept)

Description

Enbrel® decreases inflammation in the body by binding to and blocking a protein called tumor necrosis factor alpha. It is FDA approved for the treatment of rheumatoid arthritis in adult patients with moderate to severe active disease.

Dosing and Administration

Enbrel® can be self-administered subcutaneously. The recommended dose is 50 mg once weekly.

Common Side Effects

The most common side effects of tumor necrosis factor inhibitors include infusion or injection site reactions, upper respiratory infections, and allergic reactions. There is also a slight risk of more serious side effects including lymphoma and serious infections.

Humira® (adalimumab)

Description

Humira® decreases inflammation in the body by binding to and blocking a protein called tumor necrosis factor alpha. It is FDA approved for the treatment of rheumatoid arthritis in adult patients with moderate to severe active disease.

Dosing and Administration

Humira® can be self-administered subcutaneously. The recommended dose is 40 mg every other week and may be increased to 40mg weekly.

Common Side Effects

The most common side effects of tumor necrosis factor inhibitors include infusion or injection site reactions, upper respiratory infections, and allergic reactions. There is also a slight risk of more serious side effects including lymphoma and serious infections.

Remicade® (infliximab)/Inflectra® (infliximab-dyyb)

Description

Remicade® decreases inflammation in the body by binding to and blocking a protein called tumor necrosis factor alpha. It is FDA approved for the treatment of rheumatoid arthritis in combination with methotrexate in adult patients with moderate to severe active disease.

Dosing and Administration

Remicade® is an infused medication and should be administered by health care professionals only. The recommended dose is 3 mg/kg at 0, 2, and 6 weeks followed by maintenance therapy 3 mg/kg every 8 weeks. For incomplete response, the dose may be adjusted up to 10 mg/kg or treat every 4 weeks.

Common Side Effects

The most common side effects of tumor necrosis factor inhibitors include infusion or injection site reactions, upper respiratory infections, and allergic reactions. There is also a slight risk of more serious side effects including lymphoma and serious infections.

Simponi® (golimumab)

Description

Simponi® decreases inflammation in the body by binding to and blocking a protein called tumor necrosis factor alpha. It is FDA approved for the treatment of rheumatoid arthritis in adult patients with moderate to severe active disease.

Dosing and Administration

Simponi® can be self-administered subcutaneously. The recommended dose is 50 mg once a month.

Common Side Effects

The most common side effects of tumor necrosis factor inhibitors include infusion or injection site reactions, upper respiratory infections, and allergic reactions. There is also a slight risk of more serious side effects including lymphoma and serious infections.

Simponi Aria® (golimumab)

Description

Simponi Aria® decreases inflammation in the body by binding to and blocking a protein called tumor necrosis factor alpha. It is FDA approved for the treatment of rheumatoid arthritis in adult patients with moderate to severe active disease.

Dosing and Administration

Simponi Aria® is an infused medication and should be administered by health care professionals only. The recommended dose is 2 mg/kg at weeks 0 and 4, and then every 8 weeks thereafter.

Common Side Effects

The most common side effects of tumor necrosis factor inhibitors include infusion or injection site reactions, upper respiratory infections, and allergic reactions. There is also a slight risk of more serious side effects including lymphoma and serious infections.

Orencia® (abatacept)

Description

Orencia® decreases inflammation in the body by preventing T-cell activation and the production of cytokines. It is FDA approved for the treatment of rheumatoid arthritis in adult patients with moderate to severe active disease.

Dosing and Administration

Orencia® can be self-administered subcutaneously or administered by health care professionals as an intravenous infusion. The recommended dose for Orencia® as a subcutaneous injection is 125 mg once a week. The recommended dose for Orencia® as an intravenous infusion is 500 mg, 700 mg, or 1000 mg given at 2 and 4 weeks after the first dose and then every 4 weeks depending on your body weight.

Common Side Effects

The most common side effects include headache, upper respiratory tract infection, nausea, and nasopharyngitis (swelling of nasal passages or back of throat)

Rituxan® (rituximab)

Description

Rituxan® decreases inflammation in the body by preventing T-cell activation and the production of cytokines. It is FDA approved for the treatment of rheumatoid arthritis in adult patients with moderate to severe active disease and inadequately responded to at least 1 TNF antagonist therapies.

Dosing and Administration

Rituxan® is an infused medication and should be administered by health care professionals only. The recommended dose is 1000 mg given at 0 and 2 weeks, followed by 1000 mg every 24 weeks.

Common Side Effects

The most common side effects include upper respiratory tract, and urinary tract infection; infusion reactions; serious infections; and cardiovascular events.

Actemra® (tocilizumab)

Description

Actemra® decreases inflammation in the body by blocking IL-6, which is a pro-inflammatory cytokine produced by T cells. It is FDA approved for the treatment of rheumatoid arthritis in adult patients with moderate to severe active disease and who had inadequate response to one or more DMARDs.

Dosing and Administration

Actemra® can be self-administered subcutaneously or administered by health care professionals as an intravenous infusion. The recommended dose for Actemra® as a subcutaneous injection is 162 mg once every week or every other week depending on your body weight. The recommended dose for Actemra® as an intravenous infusion is 4 mg/kg every four weeks, following by 8 mg/kg every four weeks.

Common Side Effects

The most common side effects include upper respiratory tract infections, nasopharyngitis (swelling of nasal passages or back of throat), hypertension, increased ALT, injection site reactions, and headache.

Kineret® (anakinra)

Description

Kineret® decreases inflammation in the body by blocking IL-1, which is a pro-inflammatory cytokine produced by T cells. It is FDA approved for the treatment of rheumatoid arthritis in adult patients with moderate to severe active disease and who had inadequate response to one or more DMARDs.

Dosing and Administration

Kineret® can be self-administered subcutaneously. The recommended dose is 100 mg daily.

Common Side Effects

The most common side effects include headache, vomiting, joint pains, injection site reaction, fever, and nasopharyngitis (swelling of nasal passages or back of throat).

Xeljanz®/ Xeljanz® XR (tofacitinib)

Description

Xeljanz®/ Xeljanz® XR decreases inflammation in the body by blocking Janus kinases (JAK), which has a role in immune cell function. It is FDA approved for the treatment of rheumatoid arthritis in adult patients with moderate to severe active disease who had inadequate response to methotrexate.

Dosing and Administration

Xeljanz® is a 5 mg tablet that is typically given orally twice daily. Xeljanz® XR is an 11 mg tablet that is typically given orally once daily.

Common Side Effects

The most common side effects include headache, upper respiratory tract infections, diarrhea, and nasopharyngitis (swelling of nasal passages or back of throat)