For me, about 35 years, I reckon.  Started having symptoms in young teens, wasn't dx'd until 23 yrs ago, though.  Yeah, I know that the biologics can be crazy.  I am not sure what decision I would make if it comes to that.  I do know that I can not and will not do pred again (or any other steroid).  My primary doc (who I have appointed my team leader of physicians) has straight up told my rheumy that I am NOT to have any steroids.  Mental health is health, too.  
Just cuz a rheumy is "the best" doesn't mean s/he is actually the best.  The first one I went to un-dx'd me, and she was the best in cinci area.  She went only by bloodwork, which is a big no-no.  Not to mention that that was the -only- time in my history that I was seronegative.  I almost drove off a bridge that day.  I'm glad I didn't, because, come to find out, I had gone into remission, my body just didn't feel it yet.  Was in remission for 8 yrs, and it just struck again a little over a year ago.  I decided to go aggressive this time.  
Was also thinking a box mod or something wider, but worried about the weight.  It would be nice to have a local shop where I could just pick it up and feel the weight.  I chainvape pretty constantly, at least right now in the beginning, so that's kind of important.  Not to mention that I have had problems in the past smoking analogs!  I smoke left-handed, and it would send those zappy pains down my hands and I would have to use my compression gloves.  This was during flares, which have mostly stopped with the MTX.