I think what Emily says is also 100% accurate. Lets take methotrexate, an immuno suppressant that most of us with RA take (or some variant of it). It is the first line of defense for RA and almost all patients are placed on it immediately at diagnosis. It is a generic drug and it costs about $20 per month. It works well, it is about 20 years old. Today for RA it remains the first drug prescribed but it is not the last.
20 years ago it was the miracle drug and it originated in cancer research (Many RA drugs do). After about 6 months the current gold standard is to transition a person to a regular biologic immuno suppressant. Why might you ask? Well researchers now know that RA is an evolving issue. For some people about 15% methotrexate is the end all drug. but for about 85% of people the body evolves further to thwart the effect of the suppression of the immune system.
So we ramp it up with a biologic supressant. you see these on TV, Remicaide, Humaria, orencia, i take the grand daddy of the lot Rituxan. I started with a relatively older drug remicaide and it worked well for 8 years. But when it gave out it was over in a flash. Boom I was in need a different drug.
Not everyone will have this and it is difficult to knwo who will and who will not. While my first one lasted a long time, the second lasted less than a year. This is pretty typical in many forms of Rheum disease. Incidentally that are at least 4 causes of RA, and one might expect a similar understanding to grow with type 1 diabetes. What works for you might not work for me and what works for all of is might not work for all of them.
What is known is that autoimmune diseases (some believe there are over 100) are not a one size fits all. One treatment that is effective for me may not be effective for you and vice versa.
I have great hope for this. I have seen first hand the incredible power of immune suppressants, but I have also seen the many failures. I think we are in a wait and see. Even today 15 years after taking my first biologic department I am still hoping for a great one size fits all. unfortunately this bride is 300 lbs some days and 200 labs others.
best to all,