Infusion Treatments for Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an autoimmune disease that causes crippling pain and deformities to the joints. While no cure for the diseases exists, medications that relieve the symptoms are available. Today, more medications are being administered intravenously to treat rheumatoid arthritis. While there are many benefits to the drugs, they also bring their own sets of side effects; some of these can be severe.

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Corticosteroids decrease inflammation. In serious cases of RA which have not responded to standard treatment, corticosteroids may be given intravenously to reduce swelling and pain in the joints. Corticosteroids have numerous undesirable side effects, from an increase in bone loss to the possibility of steroid-induced psychosis. Other side effects include ulcers in the gastrointestinal tract, skin thinning, weight gain, severe infection from immune system suppression and cataract formation.


Orencia decreases RA symptoms by interfering with the activation of T cells, which increase inflammation. Orencia is given once a month over 30 minutes to an hour, after an initial loading dose program of doses at baseline, at two weeks and at four weeks. It takes up to three months for a positive response to be seen. Because Orencia reduces the immune system response, opportunistic infections and malignancies are possible side effects. Respiratory problems, such as pneumonia, may also occur. Infusion reactions, such as:

  • fever
  • chills
  • tremors
  • headache
  • nausea
  • may occur
  • but they are usually mild

According to the University of Maryland Medical Center, Orencia and Rituxan should be used only in people with moderate or severe disease who have not been helped by other medications 2.


Remicade binds with tumor necrosis factor (TNF), a substance produces by white blood cells that induces inflammation. Large quantities of TNF are found in rheumatoid joints. Remicade is administered intravenously over two hours, starting with a dose at baseline, one at two weeks, then six weeks, then eight weeks thereafter, according to the Johns Hopkins Arthritis Center website 1. Serious opportunistic infections, including tuberculosis, may occur in people receiving Remicade. Liver toxicity and bone marrow suppression are potential side effects. Infusions reactions, such as:

  • body aches
  • fever
  • chills
  • headache
  • may also occur

People with congestive heart failure cannot take Remicade, according to the New York University Medical Center School of Medicine 2. People receiving the drug should not be given live vaccines such as German measles, chicken pox and polio.


Rituxan decreases inflammation by binding with B cells, important in the activation of immune responses, and removes them circulation. Results may not be seen for up to three months after an infusion. One infusion, however, may reduce symptoms for between six months and two years. Rituxan is administered intravenously over three to four hours. Two doses are administered, two weeks apart; the drug may then be given every six months or more, if symptoms are still under control.

Infections, including reactivation of viruses, such as hepatitis B, may occur after infusion. The risk of cancer of may be increased, says the Merck Manual website. Corticosteroids are usually given intravenously along with Rituxan. Rare but fatal viruses, such as progressive multifocal leukoencephalopathy (PML), a brain infection, have occurred in people receiving the drug, the Ohio State University Medical Center reports 2.