你的Ra身体如何对生物制剂感觉

对于艾琳戴维森，33，生物学是生命。没有这种药物，她努力走一段楼梯。或者保持清醒，直到她6岁的儿子雅各布，睡觉。或者完全是功能。

戴维森最近不得不阻止她生物治疗for rheumatoid arthritis (RA) prior to a minor a surgery, and the difference is significant.

“The simplest of tasks are difficult to do because of fatigue and flares,” says Davidson, who shares her patient experience on her blog, Chronic Eileen.

With the help of her medication—which is Actemra (tocilizumab)—she’s able to “handle some of the smallest things a healthy person would normally take for granted.”

但是，在不列颠哥伦比亚省温哥华生活的戴维森，并于2015年被诊断为RA（她也有骨关节炎或OA），也没有在生物学的最容易的时间。她在前类型的药物上经验丰富的睡眠障碍，增加抑郁症，恶心和胃痛。

All biologics, which are large protein antibodies that target the inflammatory response that causes RA and are given either by...

1. Infusion (IV)
2. 注射

与大多数药物一样，生物学通常具有长期副作用的长期效果。他们也是强大的治疗师。

The key is finding the right balance. “Biologics are generally more effective in treating RA symptoms than non-biologic medicines, and even in some cases, safer,” says Justin Peng, M.D., a rheumatologist at Arthritis and Rheumatism Associates in Washington, D.C.

“与所有药物一样，应该与医生讨论风险和益处，以便可以为个体患者开发最好的治疗计划。”

目标总是呢？尽可能地减少你的RA活动。当你知道生物制剂可能让你feel—both positively and potentially not so—you’ll be better able to navigate any pitfalls and make smart changes to get you where you need to be.

Side Effects of Biologics (and What You Can Do About Them)

副作用包括但不限于这些（按大部分最少共同的顺序）：

• 感染
• Irritation at the injection site
• 头痛
• Nausea
• 过敏反应
• Heart failure (but only in those with prior heart disease)
• Increased risk of certain types of cancer

Yes, some of these side effects are scary, including the possibility of cancer (“although studies are mixed and a causal relationship has not been proven,” Dr. Peng says). But biologics are worth your consideration even with these potential risks, he says.

让我们更详细地走过两个最常见的副作用。

感染，开始。

“These medicines are all working to suppress the immune system in a way that then translates into reduced inflammation and better quality of life,” says Brian Horgan, P.A.-C., a board-certified physician assistant at Tri-State Pain Institute in Erie, PA, a comprehensive pain- and arthritis-management center.

因此，您的身体对常见病毒和细菌的防御较少。发表的数据表明，一些人群的感染风险比其他人群更高：在一个分析of 5,596 patients on biologics with inflammatory chronic arthritis (including RA) or psoriasis, 4.2% (or 289 people), had infections severe enough for hospitalization.

老年人或具有合并症的人的风险更高。最常见的感染是上下呼吸道 - 所以基本上，colds，窦感染，肺炎和支气管炎。

戴维森感冒了，她无法在她的第一个生物学，鬣狗（阿巴罗木钱）上震动。虽然在奥伦西亚（Abatacept）上，但她开发了严重的盆腔感染。

为了降低生物学而感染的风险（以及一般的，也是一般的），你不必比平常更多地完成。彭博士建议：

• Washing your hands regularly
• 避免任何人生病
• 避免可能含有有害细菌的生或未煮熟的食物
• Having vaccinations (but consult your doctor on this one first because with the lower immunity that biologics bring, certain live vaccinations may be safer to have before you start treatment)

注射侧的刺激，接下来。

According to the Arthritis Foundation, these injection-site reactions can be “fairly common,” often when starting treatment with biologics (they're less common for infusions, which are delivered through an IV).

这是在凯茜克莱姆，51岁的凯茜克拉姆，他住在纳普维尔，IL。她现在在她的肚子上发痒皮疹后，在大腿上注射了垃圾（etanercept）。AMGEN是制造嵌入式的公司，列出注射部位反应作为常见的副作用（和关节炎基础指出，标记为“常见”的副作用发生在1月10日培养药物中）。

“局部注射部位反应通常与围绕药物施用的区域的组织刺激反应相关，”HoraN表示。“局部反应通常在几天内解决。这与过敏性或全身过敏反应的不同，这可能具有严重影响。“

Here are some tips for reducing injection-site issues (which are “easily treatable”) before injecting a biologic, according to Dr. Peng:

• Ice the area
• 使用局部代理，例如局部利多卡因（但请先与您的医生讨论）
• Bring the injectable up to room temperature

How Will You Likely Feel on a Biologic?

Here’s the deal: Biologics can be “miracle drugs,” but like any other medication, they’re not perfect, says Horgan. So while you may think all of your symptoms will stop, it could be that they quiet down but with an occasionalRA flare。

对于克拉姆，她的喇叭口在没有生物学上的几个月时，她的耀斑持续了几个月。这些耀斑现在更容易管理。她能够在当地社区学院的支持人员全职工作，她无法在生物学之前做些什么。

“I definitely know I have RA. It’s not like it’s just magically disappeared,” Kramer says. “For the most part, I have flares occasionally, but usually it’s when I overdo things, or I’m letting myself get bogged down with stress, but they’re very short, and they’re nothing like what I had in the past, before getting on this biologic.”

她的手指仍然僵硬，她的膝盖偶尔会膨胀，但她可以处理这些症状。

“我再次感到正常。这只是能够再次过我的生活，“她说。

Horgan说，对生物学（和治疗目标）的良好反应是缓解的。所以你可能会期待：

• Reduction in stiffness, swollen joints, and pain
• 改善运动范围和功能水平
• Increased activity tolerance and quality of life
• Reduced inflammatory-marker activity in blood work and stabilization of joint disease progression on X-ray

“Biologics are a big piece of a puzzle made of many pieces of a patient’s treatment program,” he says.

如果您的生物学并未减轻您的症状 - 或正在增加您的副作用 - 您的医生可能会将您切换到另一个。它的迹象不起作用包括不良事件，即不会消退，没有症状浮雕，或者您培养自己的抗体，它不再有效地停止炎症（您的医生可以测试）。

戴维森目前在与前两者遇到激烈的副作用后在第三种生物学上。但审判和错误是值得的。在开始生物学之前，她尝试了18种药物总量的RA，包括甲氨蝶呤，标准DMARD., or disease-modifying antirheumatic drugs. She didn’t respond well to that药物，体验强烈的副作用。

“我很难打扰感染，我真的很麻烦，有腹泻，”她写在她的博客上。“有些药物我只能在几周内，因为他们造成了如此严重的抑郁和情绪波动。”

“当我准备开始生物学的时候，我害怕毒品，我避开了他们和我的风湿病学大约六个月，”她写道。

Now, she feels so much better on a biologic. She can write. She can keep up with her son. And she can be a patient advocate, serving as ambassador for the Arthritis Society and an Arthritis Research Canada Patient Advisory Board member.

Finding a biologic that has little to no side effects for her has meant everything to Davidson, because in addition to having reduced pain and reduced damage to her joints and organs, in the last two years she’s been on Actemra, she feels “more in control of my disease.”

When Will You Feel Better?

You’ll likely experience results, or a response, from a biologic within a few weeks, or up to about three months of your starting dose. “While the effectiveness of biologic agents varies, I usually tell them to be patient,” Horgan says.

他注意到，最佳结果通常会发生组合疗法，例如生物剂和甲氨蝶呤。

克拉姆人于2004年诊断患有RA，一直在嵌入式（第一个生物学），近10年，但她仍然记得她的RA症状在几周内改善了起始药物的症状。

“了解很多人没有良好的结果，我不希望任何人预期立即结果，”她说。“然而，我觉得我有一个乐观的观点进入它。我也意识到这一个可能结束，我会尝试另一个。ra是一个过程。“

一旦你在生物学，你可能会每三个月左右看到你的医生，让你的回复（和可能的副作用）监测。You’ll typically have blood work done at those visits, to test your levels like inflammatory markers and blood-count abnormalities, according to Dr. Peng, which can measure for the effects of long-term use of medication and infections, among other issues. These tests will help your healthcare team monitor your body’s ongoing reaction to the drug.

如果您在经常访问之外的任何副作用 - 即使您不确定您的症状与您的药物有关，请务必致电您的医疗保健团队。他说，在生物学时，最好是积极主动，而不是冒着你的病情恶化的风险。

在霍根的社区惯例中，如果他们的RA有问题，他可能会比每三个月更频繁地看到患者，这种情况不会阻止，如残留的疼痛和炎症，或肌肉骨骼问题，如肌腱炎或囊炎。

戴维森有类似的事情发生。她尝试了六个月的行动赛，看看它是否减少了她的症状，但她仍然遇到痛苦，而且担心它可能是一个耀斑。

所以她得到了第二种意见和超声波，这表明她的痛苦实际上是ra和oa的永久性关节损伤 - 她的新生物学不是问题。

“I felt relief knowing I was on the right treatment path, keeping the inflammation at bay,” she says. “The more I understood my disease and limitations, the more I could see how Actemra was working for me overall, and I couldn’t be more grateful for advances in modern medicine.”

yumhee公园的额外报告。