For many people living with rheumatoid arthritis (RA), tumor necrosis factor (TNF) inhibitors are a common early treatment. However, they may not work for everyone or may stop working over time.¹ As a result, you may need to switch medications at some point in your RA treatment journey.¹ It’s key to work closely with your doctor and ask the right questions to make sure you’re getting the care you need.

This interactive article highlights the importance of finding and sticking with the right medication for you to help prevent RA complications and lasting joint damage. It also outlines important questions to ask your doctor about RA treatment.

Before meeting with your doctor, it may help to create a list of topics and questions to discuss during your appointment. Answer all the questions in the slideshow to receive a personalized list of questions to bring to your next doctor's visit. You will also have the option to send your results to your email inbox.

The Importance of Treating RA

Rheumatoid arthritis is a chronic condition in which an overactive immune system causes inflammation that attacks the joints.² Common symptoms include joint pain, swelling, and stiffness.³ Inflammation from RA also raises the risk of comorbid (co-occurring) health conditions that can negatively affect your quality of life. Examples of these conditions include^2-4:

	Disability and loss of physical function
	Osteoporosis (bone thinning) and fractures
	Heart, blood vessel, and lung diseases
	Increased risk of infections
	Cognitive (thinking and memory) problems and mental health conditions, including depression
	Metabolic syndrome, which leads to high blood sugar and cholesterol levels
	Cancers such as lymphoma

To help protect your joints from permanent damage and prevent other complications from RA, doctors often prescribe disease-modifying antirheumatic drugs (DMARDs), including biologics and oral small molecules.⁵ These medications aim to slow disease progression and help reduce joint pain, swelling, and stiffness associated with RA.³

One of the main goals of RA treatment is to achieve remission, which means your condition is either inactive or minimally active. You have few or no RA symptoms such as joint pain, swelling, or stiffness. Remission doesn’t mean your RA is gone, but it means your inflammation has decreased and you’re minimizing the risk of joint damage over time.⁵

It’s important for you to be monitored regularly.^5,6 This involves routine doctor visits, blood tests, and imaging.³ It’s also important for you to share details about your RA symptoms with your doctor, including how the symptoms affect daily life. This information helps your doctor track how active the disease is and determine if any adjustments to your treatment plan are necessary. The goal is to better control your RA symptoms and help you achieve remission.^5,6

If RA is left untreated, or if your treatment isn’t working, it can result in permanent damage and disability and an increased risk of comorbidities, including heart disease and infections.^3,4 Therefore, it’s essential to work closely with your doctor to manage RA effectively.

Treatment Changes When Taking TNF Inhibitors

TNF inhibitors are common biologic DMARDs used to treat RA. In fact, about 90 percent of people diagnosed with RA start treatment with a TNF inhibitor as their first biologic.⁷ Unfortunately, many people may not respond to or tolerate these medications, or they may lose response over time.¹

The American College of Rheumatology (ACR) has created guidelines to help doctors choose treatments for rheumatoid arthritis (RA). If you're taking a biologic DMARD, like a TNF inhibitor, and it’s not helping you meet your treatment targets, like remission, you can consider switching to a medication from a different class rather than changing to another drug from the same TNF inhibitor class.⁶ For example, if a TNF inhibitor isn’t working for you, your doctor might try a drug that targets a different part of your immune system to see if it improves your condition.²

In some instances, a doctor might choose to change a person from one TNF inhibitor to a different TNF inhibitor. Although some individuals may respond to a second TNF inhibitor, several studies show that switching to a different drug class in some cases may be more effective in improving RA symptoms and controlling disease activity than trying another TNF inhibitor.^1,6-8

Keep in mind that everyone’s experience with RA is unique, and people respond differently to treatments. A medication that works well for someone else might not have the same effect for you.⁶

AbbVie ABBV-US-01984-MC V1.0 Approved 6/2025