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The Orencia biologic is an IV drug that suppresses the immune system. There are multiple biologics on the market and each hit a different part of the immune response. So far, Orencia has worked the best for me.

I have been on it for nearly three years straight. I was initially on the subcutaneous self-administered injections but they did not work nearly as effectively as the IV. Now, I go to the clinic once a month and sit for anywhere between 15 and 30 minutes.

I schedule my infusions for Friday because I need the weekend to recover. I used to ask for the day off but now I am free and clear to work. I don’t generally experience any side effects except for varying degrees of fatigue.

This past week has been a bit weird for me. I experienced a very localized “flare”. I hesitate in calling it a flare because my increase in symptoms (pain, fatigue and joint stiffness) are usually globalized. I have extreme pain in my hips, knees and ankles. Joints north of the equator felt fine. I felt pain staying in any one position for more than a couple of minutes (including just standing upright). I almost have full loss of motion and just an overall heavy feeling.

I really hope it’s just the Orencia cutting out early. Even though it works the best, for me, it sometimes only lasts two out of the four weeks. But, after my infusion today, I feel worse. I slept for almost 5 hours, totally lost to the world and when I woke up I felt like I was dying.

I won’t really worry until Monday because it takes a couple of days for the medication to kick in but, if the pain doesn’t go away by the beginning of next week then it’s probably not a flare and there must be something else going on, right?


Hi, my name is Monica and I have RA.