I had a friend once tell me she would never take one of the biologics. They have too many side effects and have dangerous complications. My friend didn’t have rheumatoid arthritis.

Rheumatoid arthritis and many of the other inflammatory or autoimmune diseases cause disruptions in the body. Pain that overwhelms. Fatigue that immobilizes.

So when the medical community came up with the biologic medication that promised relief, those with RA wanted just that.

I am currently on Actemra, tocilizumab. It is a biologic medication that can only be given by injection.  It interferes with the process of Interleukin-6. Like most RA biologics Actemra reduces symptoms  about 50%. It doesn’t cure. It just helps.

The dangers of the biologics are real. The need for RA relief is also real. How do we avoid serious complications when we are prescribed biologics for our rheumatoid arthritis?

First and foremost, it is very important that your doctor is aware  of your complete medical history.

1. Your doctor will order a TB test. She will order  labs periodically to check on your liver and kidney function.

• If you are 50, you should be sure to have the new shingles vaccine, Shingrix even if you have had the older one.   It  more effective. It is not a live vaccine so can be administered after you have started a biologic. Most people have been exposed to chicken pox whether or not they remember having it. Shingles is a nasty, delayed complication of chicken pox that can be activated when a person is receiving a biologic. Shingrix will protect you.

• There are biologics that should be avoided if you have heart disease.

• There are biologics that should be avoided if you have had cancer. Your doctor will know the biologics to avoid if you have either condition.

• Actemra like many of the biologics  can reactivate histoplasmosis which I have had.  My rheumatologist ran a blood test, I have no histoplasmosis activity in my body.

• I have had diverticulitis. Actemra can cause a rupture in the intestinal wall. My doc’s answer to this issue is simple. If I have any intestinal issues, I should go to the ER.  Not  reassuring but not enough to stop taking it. The symptoms are too incapacitating.

• Serious infections are a major complication of the biologics. Your immune system is suppressed. Your body might not be able to ‘fight off’ an exposure to an infection. Avoid exposure to family and friends who have an infection.

It is also important that you take good care of yourself.

• Avoid working long hours.
• Spend more time sleeping.
• Choose rest over more work whether at home or in the office.
• Be sure to have enough protein plus vegetables and fruit.

The biologics do not cure rheumatoid arthritis. They do not even stop all the symptoms of RA. But they can stop enough of the symptoms to make life manageable.