Question posted by miwatson007 on 1 Dec 2011
Last updated on 11 August 2013 by jum2017
My mother, 65, who has extreme rheumatoid since 35, just had her 9th infusion yesterday. She has felt little to no relief up to this point. The doctor says it sometimes takes up to 6 or 7 months before the patient feels relief.
Has anyone taking Orencia felt the bulk of their relief after the 9th or 10th infusion without having felt much relief before that?
Orencia takes a long time when it works the way it is intended. Basically you will stop making so many Helper T cells because of the blocked education by APCs. It will take a long time for existing ones targeted to your RA causative proteins to die even if new ones aren't being made so quickly. Those Helper Ts, are being used to induce clonal expansion of B cells that are producing Abs which are most likely the effector of the disease. One of these Th cells can turn on many B cells. So the eventual reduction of these B cells is also going to take additional months. Finally, you have to wait for the antibodies produced by these Bcells to leave circulation. That has a half-life of about 20 days. So lets say another month.
There is an immediate affect experienced by some people, but this is a different mechanism where the APCs themselves are suppressed by Orencia and not common. Don't listen to the circus. It is supposed to take time, though I would guess about 3 months.
From my understanding there should have been some benefit felt by now ... if not then it is not working for your mum.
She was on Embril for 12 years before late surfacing side effects forced her off.
If Orencia doesn't work what would be a good next step or drug to try?
You would need to discuss with her doctor as to what the next step in treatment would be. All the very best.
The link below has names of medicines which can be used to treat rheumatoid arthritis ... you may find the information helpful.
As one who has used biologic agents, I have experienced considerable relief after no more than 3 months - usually within days. If I were the patient, I would want to try something else if there isn't at least a 50% reduction in pain and swelling by the end of the 4th month. Just my opinion.
I've never heard of having to wait that long before trying something else, usually it is 3-4 months. If your mum can't take tnf blockers there is also Actemra and Rituxan.
orencia, rheumatoid arthritis, doctor
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