9 YEARS ON REMICADE - IS IT TIME FOR ME TO CHANGE TO ONE OF THE NEWER MEDICINES?

There could be many reasons you are not feeling any better. With the duration of your disease, it is likely that joint damage is causing a good deal of your discomfort, even if the inflammation is being suppressed. It could also be that there is reversible, active inflammation that could be better treated by another medication. The big issue is not how long you have been on Remicade but whether it has suppressed your disease activity. This is why it is important that your rheumatologist measure your disease activity carefully and treat in a way that adequately suppresses as much inflammation as possible. We have many other medications that are effective in treating rheumatoid arthritis, even when medications such as Remicade is inadequate. Other "biologic" drugs to consider include Enbrel, Humira, Simpooni, Cimzia, Rituxan, Orencia, and Actemra. The latter 3 medications listed have a different mechanism of action than Remicade and for certain patients may be a better option. I would encourage you to engage your rheumatologist in a discussion of these options to see which choice is most appropriate for you. Best wishes!