Dear Mary, I tried Humira first, but it did not help my hands (which are my main area of arthritis). Then I tried Enbrel, which DID help my hands. I have stuck with it for 2 years. I have not really had any side effects, except when I get a flu it can last longer than average. I do not seem to pick up more colds than anyone else. I had to stop Enbrel a couple times when I had the flu, but was able to go right back on it. I really do not want to try Remicade because the process seems so involved with going for infusions, but I know someone who is much improved on it. Either Enbrel or Humira are easy to use-a once a week injection. I am not familiar with orencia. Good luck! Kera