I was diagnosed with RA in my mid fifties. I started on methotrexate which worked well, but negatively impacted my liver. I was switched to Enbrel and did well for several years. Then during a stressful period my Vectra D score was elevated. The doc switched me to Humira My Vectra continued to be elevated so he trie Orencia. That did not work either. I was then given actemra. Aftrer three infusions I developed a rash. At that time I was retested for TB and was found to have latent TB. I was treated for that and then found to have MRSA. I was treated for that. I was off of meds for two years I am back on Enbrel and it is working quire well. RA is difficult and painful. I have several other autoimmune disease that are challenging me right now….Pemphigus Vulgaris in the esophagus and alopecia areata. Good luck. I hope Actemra works for you.