Remicade, Enbrel and Humira are members of a new class of anti-rheumatic medications collectively known as "biologics". These three medications all are very powerful and effective anti-inflammatory medications that work by inhibiting a "cytokine" or cellular protein called Tumor Necrosis Factor or TNF.

These medications have some serious risks. There have been deaths reported due to infections, Tuberculosis, and even cancers, especially lymphomas. It is very important to know, if you are taking one of these medications, that if you become ill with an infection, you should stop the medication immediately and notify your doctor. No one should take these medications without first having a PPD skin test to rule out latent Tuberculosis.

It is unfortunate that these medications are advertised on television. The ads do not stress the high risk invovled with these medications, and they give the impression that they should be prescribed to anyone with arthritis. This is far from the truth. These medications are reserved for the most severe cases that do not respond to more appropriate medications such as Methotrexate, Arava, Plaquenil and others.

We do use all of these medications in the toughest cases. People with severe destructive arthritis that has not responded well to the other regular medications.

If you are on one of these medications, remember to go to the lab every month for your CBC. If you get a fever, or become ill, stop the medication and notify your primary care physician.