What medications for rheumatoid arthritis (RA) work for you?

linda,
A new test from Aqtual uses machine learning to analyze cell-free DNA (cfDNA) from blood samples, allowing clinicians to choose the most effective biologic drug.
https://aqtual.com/ clinical trials ended in 2025. It is supposed to be available this year.
Then there is PrismRA https://www.prismra.com/get-prismra/
My sister has had excellent results with Enbrel and methotrexate for over 20 years. When her doctors take her off methotrexate or try to put her on one of the newer TNF inhibitors, she suffers.
It looks like the process is going to become more accurate and easier. Best wishes
You might call both of these companies.

I used Plaquenil and it worked great but then I started with issues so i stopped it can't take methotrexate or leflunomide. doc says there are other treatments though he didn't say what, but they are very expensive.

Methotextrate for 20 years no problem

Methotrexate can upset the liver especially if you have issues or had like I did with non-alcoholic fatty liver

I have been using Orencia since 2019.

I was on Actemra for 8 months - it worked, but Actemra gave me GI toxicities. I have switched to Humira, which was better tolerated and also worked.
Methotrexate also worked on joints but gave me fatigue and skin rashes.

Leflunomide and Rituxin.

Leflunomide works well for me also.

I was diagnosed with Rheumatoid Arthritis 23 years ago at age 53. I switched specialists within the first year and was then treated at Hospital for Special Surgery in Nee York City. I learned very quickly to be proactive regarding choice of specialist. It is my understanding that the standard approach to a new diagnosis is to begin treatment with the most common medications used for new patients along with pain medication if needed. Then it is a ‘see how it goes’ in the subsequent weeks and months. Each medication may or may not help. Frustrating when you try several, that can have different ways of working and your pain is still there. In the first five years from memory I was prescribed 4 or 5 different meds. This is the only way to find one that bingo! Works Well for you. You might stay on it for a time and then find it doesn’t work as well as it used to. So you go up the scale to the next med the doctor chooses for you based on your own individual symptoms. The disease can progress also leading to another choice by the doctor.
It is common to ‘go through’ several meds - don’t be discouraged. You are important to your own care. Always report any new symptoms - patient portals are great for this.

@e74
I was on Rituxan for several years very successfully. However I then went into a one year phase where my autoimmune system was so depressed i was constantly sick with one infection after another. I was prescribed antibiotics 10 times that year because they had to treat the infections. When my Dr switched me to Simponi I did much better for a while. I have now been on Orencia very successfully for about 5 years.