Suffering from Pain
Hello Doctor, This question is for my 53-year-old mother-in-law who has been having rheumatoid arthritis for about 30 years. She has had bilateral hip and knee replacements, and her last operation was done about 5 years ago. Things were going fine until about 2 months ago when she started having severe neck and shoulder pain, sometimes radiating to her arms. We did consult her regular rheumatologist, who has asked her to begin Adalimumab injections, twice a month. We came to know that there are severe sideeffects to the drug and would like to know more about it and the success percentage of Adalimumab injection. It would be great if you could help us find other treatment alternatives that we can look up to.
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Dr. Akash P Rangari
Joint Replacement Surgeon 8 yrs exp Hyderabad

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Hello Dear, Its true that adalimumab have few severe side effects but those r justified because rheumatoid arthritis is an auto immune disorder that means our own immunity is behaving abnormally, and adalimumab is somewhere reducing our own immunity and thus increase the risk of infection but that is the treatment of auto immune disorder. It is essential in this patient because at the age of 53 she has undergone bilateral hip and knee replacement and still having pain and other symptoms that means her disease is progressing, so we need to give her something which not only reduces her pain but also reduces the progression of disease. If we talk about its success rates then yes it is effective in reducing symptoms and progression of RA. Regarding other treatment options there are many like analgesics NSAID's , DMARD's like methotrexate and hydrochlroquine but for sure your rheumatologist must have tried these because adalimumab is mostly started when these fails to give relief. There are also drugs like adalimumab i.e. etanercept,infliximab but adalimumab is more effective and easily tolerable. I would suggest you to only take these medications under guidance of rheumatologist because side effects have to be monitored and treated on time. Actually it's very big topic to discuss about,not possible to write everything. You can research more by going through article on " safety and effectiveness of adalimumab for treatment of RA" Hope it helps.
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