Treatments for Rheumatoid Arthritis

While there is no cure for rheumatoid arthritis (RA), there are treatments that can help relieve the pain, stiffness, and swelling caused by the condition. Some of the typical treatment options your doctor may consider are described below. It’s important to talk to your rheumatologist to determine which treatment option is right for you.

NSAIDs

Often prescribed by doctors when RA first starts, nonsteroidal anti-inflammatory drugs (NSAIDs) help reduce pain, stiffness, and swelling. Many NSAIDs like ibuprofen (such as Motrin^®* and Advil^®*) and naproxen (such as Aleve^®*) are available at drugstores without a prescription. Others, like Celebrex^®*, require a prescription. Over time, many people find that NSAIDs may not be enough to provide the symptom relief they require.

^*Indicated trademarks are registered trademarks of their respective owners.

DMARDs

Your doctor may have prescribed a medicine called a DMARD (disease-modifying antirheumatic drug) to help treat your RA. Methotrexate is a commonly prescribed DMARD for RA. While many people are helped by methotrexate, for others, it isn’t enough. Your doctor may combine methotrexate with other medications to help relieve your symptoms and treat your RA.

Biologics

Doctors have found that when methotrexate is combined with some biologic treatments, such as SIMPONI^®, the two medications working together can be helpful in controlling the symptoms of moderate to severe RA.

SIMPONI^® is the first and only self-injectable biologic treatment for adults with moderate to severe RA that requires just one injection each month. SIMPONI^® is taken with the medicine methotrexate, as directed.

Once you and your doctor are comfortable with the self-injection process, you will inject SIMPONI^® under the skin, just once a month.

Just one injection of SIMPONI^® each month relieves the pain, stiffness, and swelling of moderate to severe RA. Your results may vary.

Selected Important Safety Information

SIMPONI^® (golimumab) can lower your ability to fight infections. Serious and sometimes fatal events may occur. There have been reports of serious infections including tuberculosis (TB) and infections caused by bacteria, fungi, or viruses that have spread throughout the body. Other possible serious side effects may include lymphoma, skin cancer, a rare and fatal cancer called Hepatosplenic T-cell lymphoma, other cancers, hepatitis B, heart failure, nervous system problems, or allergic reactions. To learn more about these and other risks, please read the Important Safety Information, and the Medication Guide, and talk with your doctor.

Next: What is a Biologic?

SIMPONI^® is a once-monthly self-injectable biologic treatment for adults with:

moderate to severe rheumatoid arthritis (RA), with the medicine methotrexate
active psoriatic arthritis, alone or with the medicine methotrexate
active ankylosing spondylitis

Methotrexate is used as directed.

Once you and your doctor are comfortable with the self-injection process, you will inject SIMPONI^® under the skin, just once a month.

SIMPONI^® is used in adults with moderate to severe active ulcerative colitis (UC) when certain other UC medicines have not worked well enough or cannot be tolerated, or if it is necessary to continue taking steroid medicines:

to begin helping some of your symptoms
in people who respond to SIMPONI^®, to get their UC under control (induce remission) and keep UC under control
(sustain remission)
to begin to improve the way the lining of your large intestine looks to your doctor during colonoscopy

SIMPONI^® is a self-injectable biologic treatment given every 4 weeks after
2 starter doses.

Once you and your doctor are comfortable with the self-injection process, you will inject SIMPONI^® under the skin.

IMPORTANT SAFETY INFORMATION

SIMPONI^® (golimumab) is a prescription medicine. SIMPONI^® can lower your ability to fight infections. There are reports of serious infections caused by bacteria, fungi, or viruses that have spread throughout the body, including tuberculosis (TB) and histoplasmosis. Some of these infections have been fatal. Your doctor will test you for TB before starting SIMPONI^® and will monitor you for signs of TB during treatment. Tell your doctor if you have been in close contact with people with TB. Tell your doctor if you have been in a region (such as the Ohio and Mississippi River Valleys and the Southwest) where certain fungal infections like histoplasmosis or coccidioidomycosis are common.

You should not start SIMPONI^® if you have any kind of infection. Tell your doctor if you are prone to or have a history of infections or have diabetes, HIV or a weak immune system. You should also tell your doctor if you are currently being treated for an infection or if you have or develop any signs of an infection such as:

fever, sweat, or chills
muscle aches
cough
shortness of breath
blood in phlegm

weight loss
warm, red, or painful skin or sores on your body
diarrhea or stomach pain
burning when you urinate or urinate more than normal
feel very tired

Unusual cancers have been reported in children and teenage patients taking TNF-blocker medicines. For children and adults taking TNF blockers, including SIMPONI^®, the chances for getting lymphoma or other cancers may increase. Hepatosplenic T-cell lymphoma, a rare and fatal lymphoma, has occurred mostly in teenage or young adult males with Crohn’s disease or ulcerative colitis who were taking other TNF blockers with azathioprine or 6-mercaptopurine. You should tell your doctor if you have had or develop lymphoma or other cancers.

Some people treated with SIMPONI^® have developed certain kinds of skin cancer. If any changes in the appearance of your skin or growths on your skin occur during or after your treatment with SIMPONI^®, tell your doctor.

Tell your doctor about all the medications you take including ORENCIA (abatacept), KINERET (anakinra), ACTEMRA (tocilizumab), RITUXAN (rituximab), or another TNF blocker, or if you are scheduled to or recently received a vaccine. People taking SIMPONI^® should not receive live vaccines.

Reactivation of hepatitis B virus has been reported in patients who are carriers of this virus and are taking TNF-blocker medicines, such as SIMPONI^®. Some of these cases have been fatal. Your doctor should do blood tests before and after you start treatment with SIMPONI^®. Tell your doctor if you know or think you may be a carrier of hepatitis B virus or if you experience signs of hepatitis B infection, such as:

feel very tired
dark urine
skin or eyes look yellow
little or no appetite
vomiting
muscle aches

clay-colored bowel movements
fevers
chills
stomach discomfort
skin rash

Heart failure can occur or get worse in people who use TNF blockers, including SIMPONI^®. Your doctor will closely monitor you if you have heart failure. Tell your doctor right away if you get new or worsening symptoms of heart failure like shortness of breath or swelling of your lower legs or feet.

Rarely, people using TNF blockers, including SIMPONI^®, can have nervous system problems such as multiple sclerosis or Guillain-Barré syndrome. Tell your doctor right away if you have symptoms like vision changes, weakness in your arms or legs, or numbness or tingling in any part of your body.

Serious liver problems can happen in people using TNF blockers, including SIMPONI^®. Contact your doctor immediately if you develop symptoms such as feeling very tired, skin or eyes look yellow, poor appetite or vomiting, or pain on the right side of your stomach.

Low blood counts have been seen with people using TNF blockers, including SIMPONI^®. If this occurs, your body may not make enough blood cells to help fight infections or help stop bleeding. Your doctor will check your blood counts before and during treatment. Tell your doctor if you have signs such as fever, bruising, bleeding easily, or paleness.

Rarely, people using TNF blockers have developed lupus-like symptoms. Tell your doctor if you have any symptoms such as a rash on your cheeks or other parts of the body, sensitivity to the sun, new joint or muscle pain, becoming very tired, chest pain or shortness of breath, swelling of the feet, ankles, and/or legs.

New or worse psoriasis symptoms may occur. Tell your doctor if you develop red scaly patches or raised bumps that are filled with pus.

Tell your doctor if you are pregnant, planning to become pregnant or are breastfeeding or have a baby and were using SIMPONI^® during pregnancy. Tell your baby’s doctor before your baby receives any vaccine because of an increased risk of infection for up to 6 months after birth.

Tell your doctor if you are allergic to rubber or latex. The needle cover contains dry natural rubber.

Tell your doctor if you have any symptoms of an allergic reaction while taking SIMPONI^® such as hives, swollen face, breathing trouble, or chest pain. Some reactions can be serious and life-threatening.

Common side effects of SIMPONI^® include: upper respiratory tract infection, reaction at site of injection, and viral infections.

Please read the Full Prescribing Information and Medication Guide for SIMPONI^® and discuss any questions you have with your doctor.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

This site is published by Janssen Biotech, Inc., which is solely responsible for its contents. The material on this site is intended only as informational or as an educational aid and is not intended to be taken as medical advice. The ultimate responsibility for patient care resides with a healthcare professional.

The information on this site is intended for the use of patients and caregivers in the United States and Puerto Rico only. Laws, regulatory requirements, and medical practices for pharmaceutical products vary from country to country. The Prescribing Information included here may not be appropriate for use outside the United States and Puerto Rico.

Last updated May 16, 2013