How does a biologic like Inflectra actual work? Basic questions

RB, Inflectra is a biosimilar to Remicade, for lack of a better word, it's like a generic version of Remicade. It's cheaper than Remicade & this is why insurance company's has forced patients off of Remicade on to Inflectra. It's in the class of TNF blockers like Humira & several others, they all work the same way.

The purpose of the loading doses is to get a get a jump start on tamping down inflammation. This was how my dr explained it to me back when I was on Remicade. How long it stays in your system depends on how your body metabolizes it. Some people can go 8 weeks in between infusions, where others need them every 4, 5 6 or even 7 weeks, same with increasing the dosage to 10kg. Time determines what your needs are that works best for you. You cannot compare your situation to others, too many different factors involved. Keep track of how you feel the closer to your infusion date, if you see consistency in symptoms by the 7th week, a change can be made.

I've read your posts & from what you have said you are seeing some improvement which is great. If you had zero improvement or was getting worse, then I would be concerned. You still have options with the Inflectra. Don't let yourself get hung up on "I should be responding faster than this or what if", because you read about someone else. That causes too much undue stress & medicine just doesn't work that way on everyone.

Not all drs will add Imuran or 6mp to the mix, it's strictly the drs choice. You can ask your dr & see what he says, no harm there. I've seen it added to a lot of RA people.

With any medication it's time & patience. You can go to their website & read about it, lots of info there. Take care.

Biologics interfere with a specific stage of the immune system's initial attack signalling (infliximab/tnf-alpha), WBC trafficking (entyvio/madcam), or attack completion (stelara/IL) stages. By ceasing the immune attack, inflammation doesn't happen in our intestines, and we heal and feel better.

Inflectra/infliximab/remicade is known as a tnf-alpha blocker. When cells in your body request an immune attack, they produce a protein called tnf-alpha. This is the initial battlecry that summons an attack and inflammation. Tnf-alpha goes through your bloodstream. Once it arrives at it's destination, the immune system's attack dogs (WBC) are released into the blood stream and attack their target.

Inflectra infusion gives you tnf-alpha blocking proteins into your blood. If one of those proteins encounter one tnf-alpha protein within your blood, they dock, the pair become inert and pass harmlessly out of your body without causing inflammation in that one instance. There are many millions of tnf-alpha blocking proteins in one infusion.

Ideally, there's enough inflectra to get you by from infusion to infusion without running out. Dosage can be adjusted if needed. There's a blood test given at minimum concentration, just before your next, scheduled infusion to verify dosing.

Yes, levels fluctuate between infusions. Highest at infusion, lowest before next infusion. It should never get too low though. Your symptoms should remain constant and not wane between doses. Only expect a wane during the initial loading doses. Once in maintenance phase (every 8 weeks) you should remain stable.

Pairing inflectra with azathiopurine/imuran is kinda oldschool. Used to be common and now uncommon. Initially thought to reduce the creation of antibodies against inflectra (antibodies make a med less effective over time and cease it working entirely). Pairing has risks and some still get antibodies despite that pairing. It's just not as necessary as it initially seemed.

Humira and inflectra are very similar, like Coke and Pepsi sodas are. There's slight differences, some claim one is better than the other but there's not significant evidence to backup that claim.