Hi hopenoel , When taking methotrexate I was on a weekly dose increase and nowhere near the therapeutic level when several side effects happened at once. Nausea, shortness of breath, headaches, episodes of afib. Stopped methotrexate. Started Enbrel which cleared my skin within a month (I had about 40% plaque cover), noticed more energy immediately, increased range of motion, and decreased pain. Side effects were nausea, headaches, and sinus problems. TNF-alpha's seem to work best for me; Enbrel having the fewest unwanted effects.
Like you say, always vigilant re possible infections, especially with Enbrel being every week.Enbrel is the only med I haven't had night sweats on. Three out of seven days I'm usually symptom and side effect free. Compared to other biologics and DMARD'S that's a ratio I can live with and be thankful for. Always aware everyone responds differently to these drugs.
Re safety of these very powerful drugs the lyrics of L. Cohen often goes through my mind, "Everybody knows that the dice are loaded; everybody rolls with their fingers crossed." Best wishes to you for decreased symptoms and healthy outcomes.