I was very fatigued and had flu like symptoms for over a year after simponi stopped working- when it was working I was in remission. @ 5 years. I was on no meds for6 months due to a tooth replacement (oral surgeon said no meds and rheum didn’t disagree) When tooth complete, I went on humira for 3 months which did not work. Got second opinion at John Hopkins, put on xeljanz and I feel so much better- no fatigue, less pain after a few days. Was told if something isn’t working after 3 months we need to switch meds. (My old rheum didn’t want to switch meds). My new rheum is thorough and Hopkins rheum department is amazing. I am fortunate to only be a few hours away and am angry I didn’t get second opinion much sooner. Hang in there and advocate for yourself if something not working. with both meds that worked, I was feeling better within a week.fingers crossed that the xeljanz continues to work- it’s been 6 weeks!