The side affect I had with Actemra was diverticulitis. Because of that we had to stop the Actemra. I had diverticulitis a few years prior but decided to try Actemra since enough time had passed. Then we decided to give Methotrexate a try. That made me extremely tired. I had no energy. Just walking up steps was a chore and I would fall asleep just sitting on couch in afternoon while watching my grand kids. We stopped the methotrexate injections and my energy came back. Another relapse happened and that's when we decided to try rinvoq. If you decide to give rinvoq a try I hope it works for you. Keep me posted.