My wife was on Methotrexate for 3 years for her PSA. It gave her bad side effects. She took 8 pills every Sunday night. Monday every week she was very sick and Tuesday she could not get out of bed easily and had trouble with brain fog. 3 months ago she stopped the MTX and went on Otezla 60mgs twice a day. Her Psoriasis and pain got much worse. Otezla did not help at all. Her rhuemy wanted to put her on Cimzia but insurance would not cover that drug. He now is pushing her to take Remicaide. I'm apprehensive of this drug and it's side effects. Also since this is an infusion the half life is up to 12 days. If she has bad side effects they will linger for 12 days. She tried Humira and she developed symtoms simular to MS and could hardly walk. She had to stop Humira. Please let us know the pro's and cons of remicaide.
What about leflunomide, as an alternate DMARD? Was that discussed?
Please describe her MS symptoms.
There really shouldn't be much to worry about starting Remicade so long as she is pretreated with Tylenol and benadryl (or whatever your provider uses) It takes several loading doses to get to therapeutic levels (that 12 hour you were talking about.)
I WOULD however request an MRI to see if there is any demyelination in the brain. Anti-TNFa demylination is a rare side effect of the biologics but if it happened with one there is a possibility it can happen with another. However Cimzia and Remicades action is slightly different Humira so far less likely.
Did the Doc write a "nice" letter to the insurance company? Cimzia is less expensive that Remicade (in most medical centers) even though less likely to be effective.