10 Biologics for Rheumatoid Arthritis: What to Know About Humira, Remicade, and More

Rheumatoid arthritis (RA) is an autoimmune disorder where the immune system attacks the joints. Inflammation from this condition can cause symptoms such as joint pain, stiffness, and swelling. If undertreated, RA can make daily activities difficult. And if left untreated, it can cause issues such as joint damage and heart disease over time.

Disease-modifying antirheumatic drugs (DMARDs) help keep symptoms like these in check. Biologic medications are an increasingly popular DMARD class used to manage moderate-to-severe RA in adults. They reduce inflammation by blocking different immune system proteins, such as tumor necrosis factor (TNF) or interleukin-1 and interleukin-6 (IL-1, IL-6). Others block lymphocytes (B cells or T cells).

There are 10 biologic medications that are FDA-approved to manage RA. But how are they administered? And which is the best one to use? Here, we’ll break down what you need to know about RA biologics.

1. Humira

Humira (adalimumab) is one of the most widely prescribed biologics for RA. It works by blocking TNF to reduce joint inflammation. Humira is injected subcutaneously (under the skin) once every other week. But if you’re not taking Humira with methotrexate (an oral RA medication), your healthcare professional (HCP) might recommend taking Humira once weekly. They can show you how to self-administer Humira.

You should keep Humira in the refrigerator until 15 to 30 minutes before your scheduled dose. But if you’re traveling, you can store Humira at room temperature for up to 14 days.

Good to know: There isn’t a generic form of Humira, but several Humira biosimilars are available. These biologics have safety and effectiveness profiles that are very similar to Humira. They’re generally more affordable, too.

2. Remicade

Remicade (infliximab) is another TNF blocker that’s approved to treat RA. But it has some key differences from Humira.

Remicade usually needs to be taken with methotrexate when used for RA management. Another difference is that Remicade is only given through an intravenous (IV) infusion at a medical center. You’ll receive the first 3 infusions over a period of 6 weeks. But the treatment schedule becomes much more convenient after that — most people only need infusions once every 2 months.

Remicade biosimilars are available, too. These are good alternative options to Remicade that may be preferred by your insurer or available in your clinic.

Good to know: When scheduling your appointments, be sure to factor in infusion time along with travel, wait, and preparation time. The standard infusion time for Remicade is about 2 hours. Some clinics may offer shorter infusion times to those who qualify.

3. Enbrel

Enbrel (etanercept) is a TNF blocker that’s administered as a once-weekly subcutaneous injection. You can use it alone or in combination with methotrexate.

Your HCP can teach you how to administer Enbrel so you’ll feel confident giving yourself injections at home. Enbrel should ideally be refrigerated, but it can be kept at room temperature for up to 30 days. This can be handy if you’re traveling.

4. Simponi

Simponi (golimumab) is a TNF blocker that’s combined with methotrexate to manage RA. It’s unique in that it can be administered intravenously or subcutaneously.

If you’re receiving the IV version of Simponi, you’ll start off by receiving 2 doses 4 weeks apart. That’s one dose on your first visit and the next dose a month later. After that, you’ll only need an infusion once every 2 months. Infusions are pretty quick — they should only take about 30 minutes.

Alternatively, you can self-administer Simponi at home as a once-monthly subcutaneous injection. These syringes should be stored in the fridge, but they can stay at room temperature for up to 30 days if needed.

5. Cimzia

Cimzia (certolizumab pegol) is another TNF blocker that’s administered as a subcutaneous injection. It’s given every 2 to 4 weeks in the stomach or upper thighs. Depending on how much medicine you need, you may inject 1 to 2 Cimzia doses each time. If you need to administer 2 back-to-back injections, be sure to space them at least 1 inch apart to minimize injection site discomfort.

As with other TNF biologics, Cimzia needs to be kept cool in the fridge. But you can still use it if it’s stored at room temperature for up to 7 days.

6. Actemra

Actemra (tocilizumab) works differently than the five biologics mentioned above. It’s an IL-6 blocker. It should only be used if at least one other DMARD, such as methotrexate, hasn’t been effective in managing RA symptoms.

You can receive Actemra as an IV infusion once a month, and it typically takes about 1 hour each time. You can also administer Actemra to yourself at home as a subcutaneous injection once a week. If you inject Actemra at home, you should store it in the refrigerator. Room temperature storage is OK for up to 14 days too, though.

7. Kevzara

Kevzara (sarilumab) is another IL-6 blocker you can try if other DMARDs haven’t worked well in the past. You can also use it if you haven’t tolerated the side effects of other DMARDs very well.

This medication is only available as a subcutaneous injection, and it should be administered every 2 weeks. It’s best if you keep Kevzara in the fridge for it to stay effective. You can store it at room temperature if needed, but make sure you use it within 14 days. 

8. Kineret

Kineret (anakinra) is an IL-1 blocker for moderate-to-severe RA. As with other IL blockers, you’ll likely only receive a prescription for it if other DMARDs haven’t worked to control your symptoms.

Kineret is administered more often than the other medications on this list. It comes as a subcutaneous injection administered once a day. It’s important to inject Kineret around the same time every day to maintain consistent levels in your body.

You should keep this medication in the fridge until about 30 minutes before it’s time to administer the injection. But it can be left at room temperature for up to 12 hours, if needed.

9. Rituxan

Rituxan (rituximab) is used in combination with methotrexate to treat RA. It’s designed to target immune cells called B-lymphocytes. It’s another good alternative when a TNF inhibitor, such as Humira or Remicade, hasn’t effectively controlled your symptoms. Rituxan biosimilars are available, too.

For RA, Rituxan is given as two IV infusions spaced apart by 2 weeks. It's infused very slowly to prevent infusion-related reactions. Initial infusions last over 4 hours, but your second Rituxan infusion might be shorter.

After that, your HCP will help you decide when it's best to schedule your next infusions. A set of two infusions every 6 months is common. 

10. Orencia

Orencia (abatacept) works to reduce RA inflammation by blocking the activity of immune cells called T-lymphocytes. It can be administered through an IV infusion or subcutaneous injection.

As an IV infusion, Orencia is given once a month. Each infusion lasts about 30 minutes. The first month, you’ll need an extra starter dose 2 weeks after your first infusion.

Subcutaneous Orencia can be administered at home once a week. You can bring it to room temperature about 30 minutes before injecting your dose to help minimize injection discomfort, but it should stay in the fridge otherwise. And when it comes to travel, keeping Orencia chilled is crucial. Ask your HCP about how to keep Orencia cool while traveling.

Good to know: If you’re flying, it’s best to pack Orencia in your carry-on luggage to avoid temperature changes in the cargo area.

What is the best and safest biologic for RA?

There’s no single biologic that works “best” for everyone with RA. What works well for you may not work or be safe for someone else — or vice versa.

For instance, certain biologics should only be used if other DMARDs haven’t given you relief. And, depending on your health conditions, some biologics may not be safe for you. TNF blockers might worsen heart failure symptoms, for example, and IL blockers can increase the risk of stomach tears in people who have had stomach ulcers.

Cost is often a significant concern, too. Your healthcare team can help you navigate your options. Your lifestyle and personal preferences are also important to think about. For example, if you’re a frequent traveler, you may want to stick to a biologic that can be kept at room temperature for longer periods of time. You’ll also want to think about how often you’re willing or able to receive treatment. And it’s important to consider whether you’d prefer to self-administer a medication or visit a medical center for infusions.

Do biologics cure RA?

No. There’s no cure for RA. But the good news is that treatment can help control RA symptoms and reduce the risk of long-term complications.

Why trust our experts?

Written by:

Vanessa Carranza, PharmD

Vanessa Carranza, PharmD, is a pharmacist who has dedicated her career to the advancement of medical education for healthcare providers, patients, and caregivers, most notably in the oncology space.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Daphne Berryhill, RPh

Daphne Berryhill, RPh, has two decades of experience as a clinical pharmacist. She spent most of her career in the Chicago area practicing in-home infusion.

Our editorial standards

Meet our experts