Actemra (tocilizumab) - for moderate RA - thoughts ?

Discussion in 'General Discussion' started by Jason, Feb 5, 2015.

  1. Jason

    Jason Developer / Handyman Staff Member

    Doing OK on MTX 1.0ml/week.
    MTX gives her severe fatigue.
    She was going to try a Biological but was going to have to get TB treatment (her dad had TB) and she gave up.
    Thoughts on Actemra ? vs. the other biologicals.
  2. Graham

    Graham Developer Staff Member

    All the biologics require that patients first have latent TB (LTB) first treated.
    I would get a IGFR assay ( eg. Quantiferon Gold ) done to see if she has been exposed.
    If so, you can start Isoniazid for a month and then start your biologic. Enbrel may possibly be safer in that respect because it's not attacking membrane bound TNF.

    I use Actemra 3rd or 4th line because it has to be infused ie. I use it after Enbrel, Humira failure, and probably before I use Rituximab.

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