People with certain autoimmune forms of arthritis – rheumatoid arthritis and axial spondyloarthritis – may soon have more options thanks to expanding uses and a new delivery system for existing medications.

Adults with moderate to severe rheumatoid arthritis (RA) who use golimumab (Simponi) will now have the choice of getting an intravenous (IV) infusion every eight weeks instead of self-injecting every four weeks, thanks to the recent FDA approval of the infusion form of the drug, called Simponi Aria.

“You can imagine that some people might not like to self-inject,” says M. Elaine Husni, MD, vice chair of rheumatology and director of the Arthritis & Musculoskeletal Center at Cleveland Clinic in Ohio. “It’s kind of scary, I think, to one day be healthy and then be diagnosed with a disease and have to self-inject with a medication. Having that IV form and having an appointment every eight weeks would be a nice option.”

Infusions may also appeal to people who have trouble with dexterity, says Dr. Husni. “If your arthritis affects your hands, you might think about going for an infusion and not having to worry about injecting every month.” The infusions take 30 minutes and require a trip to an infusion clinic.

Both forms of the medication are meant to be used in conjunction with the disease-modifying antirheumatic drug (DMARD), methotrexate, which is a first-line for RA treatment.

Golimumab is a type of drug known as a biologic. Biologics not only help relieve symptoms such as pain, stiffness and swelling, but they can also slow the progression of joint damage. They’re often prescribed when methotrexate isn’t working well enough.

Biologics for RA target specific parts of the immune system to quiet it down. Golimumab, a type of biologic known as a TNF inhibitor blocks tumor necrosis factor (TNF)-alpha, a molecule involved in inflammation.

The injection and infusion forms of golimumab both perform well in clinical trials, says David S. Pisetsky, MD, PhD, professor of medicine and immunology at Duke University School of Medicine in Durham, N.C., though he notes that there may be some differences. With the infusion, “there is a very immediate large dose of the medication that goes in. Some people think that may be associated with some more efficacy because for a while, the potential to inhibit TNF is greater.” This could also make infection more likely, says Dr. Pisetsky, although the idea is “speculative.”