Orencia is also a biologic drug, like Enbrel, Remicade and Humira. Orencia and Remicade are both given through infusion in a hospital setting, whereas Enbrel and Humira come in pre-filled syringes with which you can inject yourself at home.
I understand your concern about the "big medications" - I've been there myself, looked at the possible side effects and wanted to curl up into a ball. And then I had a flare that took my life away and it changed my perspective. Really big problems require really big solutions and really big solutions come with a higher risk than smaller solutions. Having uncontrolled RA that damages your joint so it affects your level of ability is a pretty big problem. We all decide what risks we are willing to take and I'm not trying to tell you to do one thing or another. However, as you are researching and making the decision, think about what your life is worth to you? Going to work, taking care of your family, going out with friends, playing with the kids or the pants, do you housecleaning, not being tired all the time, having manageable pain levels - that's your real life and it's very possible that more aggressive treatment will enable you to get back to that.
Keep in mind that not everyone has all the side effects listed with a drug and although there is an increased risk of shingles, that doesn't mean that you will definitelmanageable pain levels - that's your real life and it's very possible that more aggressive treatment will enable you to get back to that.
Keep in mind that not everyone has all the side effects listed with a drug and although there is an increased risk of shingles, that doesn't mean that you will definitely get shingles. As well, although some people do have some of the more severe side effects, most experience entirely manageable side effects (last year, I wrote a post on how to manage side effects and you can read that here). I've known people who've been on Biologics for up to a decade with no major problems - they get their shots and move on with their life. For me, the Biologics had been my miracle - they gave me my life back. I couldn't do anything but be in pain and got increasingly debilitated by an uncontrolled RA flare, started taking Biologics and I have a pretty normal life now. Yes, they carry an increased risk than other drugs, but it was worth it to me. You have to do your own cost-benefit analysis, but I would encourage you to consider trying one of the Biologics. Nobody says you have to stay on it if you don't want to.