What would be the best treatment for my rheumatoid arthritis? i am presently taking prednisone, plaquenil, methotrexate shots, and actemra infusions. as has been the case in the past, i have built up a resistance to the actemra. in the past i have taken

I'm : I'm sorry to read that your RA has been so difficult to control. It would appear that you have been under the care of a qualified rheumatologist but are one of those now relatively few patients with RA that remains active despite very appropriate therapy. Based upon what you have already tried, there would appear to be very few additional options. I think that you doctor's suggestion of Rituximab is very appropriate, overall, Rituximab is quite safe and has about the same potential risks as other biologic therapies.

What else taken?: If you have not take orencia, (abatacept) Rituxan or xeljanz, those are options. You can also add Arava to your methotrexate, but you must watch the liver very closely if you do. I'm assuming you've already tried a tnf blocker.

There is no: One best treatment. Some people respond differently to all arthritis regimens! New IL-6 inhibitor called Kevzara may be subbed for your Actemra!