For the majority of my patients, I will use the TNF blockers Humira or Enbrel as my first biologic because patients can give it themselves at home and don't need to go to a clinic to get an as with Remicade. .I have the most experience with these two,(your insurance may dictate which they will pay for) You may enjoy reading my book, Arthritis without Pain. It was written a while back but it still has useful information about the TNF blockers. Newer TNF's that are now available include Cimzia and Simponi. They may be less likely to cause a burning sensation which may occur with the earlier released injections. Orencia is a different class of biologics that may be used as a first line drug. When adding a biologic, I will typically continue the MTX as up to 80 % of patients need combination therapy with a DMARD like MTX to achieve an optimal response.