Clarification: This is not disparage any particular med, we all know individual results may vary. I am troubled by the direction of the marketing, and this could be about any med.
This is a SIX PAGER, PLUS tearout MAILER in this month's Redbook (cashed in some expiring frequent-fliers, I'm flush in mags for carpool line now!).Three pages of marketing, three pages of side effects (I mean, "Important Safety Information").
One page one, we meet Diana. "I was taking mtx for my RA, but I worried about joint damage down the road." She says after she was dx'd, she went on pain mgmt., then mtx. "I had always been involved in my own healthcare, so I started doing research." She learned that RA can damage joints (what a researcher she is!) and at her next appt. asked her rheum "if there was more we should be doing."
He said her disease was still active, and it did put her at risk. "Then he said it was time to 'change the course' with Remicade."
What would he do without her to remind him of these things, I wonder?
The next page tells how well she is doing, and you get meet Dr. Schwartzmann (of NY HSS). On the third page, Diana asks Dr. S questions and he answers them.
I don't doubt that she is doing well or that Remicade helped her and she is happy with her decision. I am just troubled by advertising that seems aimed at scaring people up the ladder, even skipping a few rungs in my opinion. If mtx is a DMARD that is working for you, like Diana reported on page one, is this the new thing to do - go ahead and start Remicade because you are worried about future damage? Would any of you consider that drug just for that reason - because you are worried about future damage? And of course on page four, it says "Remicade can block the damage caused by too much TNA-alpha". Can. Not 'will'. Not 'does'. Um, I'd like my TNF-alpha levels checked first, please.....
I think this is another example of a trend I noticed in a study posted on the recent "shorter life" thread. Adding an anti-TNF to mtx supposedly reduced your cardiac risk. But they just happened to give aspirin to "many" of the study participants. Aspirin is proven to reduce your cardiac risk, hello???? Let's study mtx and aspirin, shall we? No, they want to scare you up the ladder. 'Mtx is working fine, but you are still at risk for cardiac issues unless we add a biologic.' &n bsp;
BTW, nowhere does Diana mention her arthritis is no longer active....
Well... I could see if someone who fell ill with RA wanted to take it to help them not get damage to help them keep their active life style and to not show any sign of having the disease.
But would the insurance companies approve it for you if you have not went up the ladder of meds?
I agree Suzanne. but of course you know I feel the same way as you do about those meds! Just a way to make money.
my insurance approved Enbrel when I hadn't been on ANY meds for over 10 years! go figure.
Mine won't. I had to have regular ibuprofen before they'd approve me for mobic, and I had to have mobic before they'd approve me for celebrex.Maybe Dr. Schwartzmann would answer that for you!
It also bugs me becasue she doesn't say she had damage on mtx, she was just worried about future damage. But she reports xrays show no damage since she has been on Remicade (and still taking mtx). Please, Diana, can you tell us how long you were on Remicade? Maybe the mtx was working just fine, you know?
Joonie, I know you are waiting on Remicade and I do hope so much it will help you - it's the ad, not the drug, like I said!
I have been on MTX for 17+ years and have a considerable amount of damage to my hands and knees. I learned on this baord that MTX does not stop the damage from happening and I should have taken my dr's advice and started a biologic sooner, although even 5 years ago I had damage. I agree that this ad seems to skip the other biologics, I was on Enbrel for 3 months with little relief and was moved to Remicade, because the dosage and frequency can be changed if need be. But that said, it's a paid advertisement, what would you expect them to say, go try the other biologics first?This is the way I see it. I will do all I can with the meds that don't have as many risky side effects. If those don't work I will move up and up. If there was a chance that I might get breast cancer, I am not going to go and have a mastectomy. Some people might...and they have, good for them. But that's not the road I will take. Maybe that isn't the best analogy hahaOh I was just refering to the future damage part.
It is kinda like the commercials, most irritate me. Because the people look so "normal" yet, in real life not many of us respond well enough or long enough to get to be like in the commercials.
It is kinda like hollywood skinny, pretty and rich... to be like them most want. But yet not many of us can be.
Christina - I think about the mastectomy thing all the time!
Deidre - DMARD is "disease-modify", so it can prevent damage. I would think xrays would show any progression on mtx, and then you would add a biologic (unless of course pain, swelling, etc., was too bad and you needed more than mtx).
And yes, it is paid ad, but infusions carry more risk than injections and it has been generally accepted you would fail DMARDS and injected biologics before going on to infusions. I still think this an attempt to scare people straight to the biggest guns. She says she asked her doctor and HE recommended Remicade. What they want to do is scare YOU into going in asking your doctor for Remicade.
I am so confused... I thought MTX slowed damage. and was a DMARD. Thats what my RD said. He wanted me on that more than the Sulfa. ???I'm not at all fond of drug ads.
BUT if we didn't have drug ads, we most likely would not know about the drugs that can help...without the squeeky wheels the HMOs would not let the pricey stuff on the formulary.
Can't win... still I would like to shoot the lady with the laundry basket running the basement steps... How about something real like dragging yourself up two steps clinging to the rail with both hands? (Never mind the laundry)
Christina - mtx is a dmard, it can slow/prevent damage. It is just like always, individual results vary. Keep up your xrays, no matter what you are on.
Marian - my dream home has an upstairs laundry room. Or maybe an upstairs and downstairs laundry room, plus a laundry chute just in case. I don't have RA, but have a terrible back. Most of the time, I just leave the folded clothes on top of the dryer. I come down naked nearly every morning to get dressed LOL. Thank goodness we only have girls!
[QUOTE=marian]Can't win... still I would like to shoot the lady with the laundry basket running the basement steps... How about something real like dragging yourself up two steps clinging to the rail with both hands? (Never mind the laundry)
[/QUOTE]
How about showing how one of us REALLY brushes our hair. We sure do not stand in front of a mirror or even reach up that high to brush it. I know most days I sit down and bend my head over towards my lap to brush my hair, IF I brush it at all.
How about how we REALLY button our pants... if you even wear pants with buttons & zippers. Mine would show how I walk around undone and then get hubby to button and zip them.
I mean the commercials are so misleading. But I guess if you get your RA caught before it gets BAD you would have less joint damage and problems. But not many people know what they have before they get that bad off.
This reminds me of an ad I saw for one of the ADHD meds in a parenting magazine a few years back. Personally, I think those meds are way overprescribed. Anyway, they listed a website where you could go and order a DVD to give you more information about their drug. So I ordered it, because I wanted to see just how bad the BS was.I'm going shopping this afternoon - I'll check out the ad.
I think this type of advertising is what scares the hell out of me about RA.
Pip
Here's the "patient stories" (including "Diana") onlineWell, Diane's story isn't what the ad says, according to what Suzanne printed.
And anybody else note how attractive and 'white' the 4 stories are? You'd think it only hit the well-to-do and no people of color ever got this stuff.
Pip
Aww... and they all look so well put together.
I mean I would relate better if they were dressed like I dressed. Sweat pants (no buttons or zippers), Over-sized T-shirt (easier to get on & off without assistance most times), Hair up in a scrunchie, and no makeup on. I bet the women are wearing High heels... how much ya wanna bet?
I don't know what i would do, I mean, MTX didn't work alone for me so I was never in the situation where I had to decide if I wanted to add enbrel just to prevent future damage. I needed it just so I could walk. I think that maybe I would take it just for that ( preventing future damage) reason though.
Okay, checked out Jas's link. Looks like the ad Diana, except in the ad she "has been living with RA since 2001". Link says dx'd in Spring 2002. The ad mentions pain at onset, but nothing about pain after starting mtx, just that she was worried about joint damage down the road.
"Change the course" is in both stories, though, but not much else really reads the same although it might hold up in court LOL.
Linncn, I think you would be a rare patient that would add an expensive drug like Enbrel if mtx was controlling your RA. It does speak to your good experience with Enbrel that you would consider it though - obviously no negative side effects at all.
I have two adult friends on mtx only, for years. I don't think they or their drs. would add anything, unless something changed. They aren't losing sleep over the unknown, just taking one day at a time.
[QUOTE=Pip!]Well, Diane's story isn't what the ad says, according to what Suzanne printed.
And anybody else note how attractive and 'white' the 4 stories are? You'd think it only hit the well-to-do and no people of color ever got this stuff.
Pip
[/QUOTE]I have things I cannot do now, but when I was on Humira I could do them, not the best way of doing them, but I could do them.
I am sure once I get on Remicade, I will respond well to it like I did Humira, I always seem to respond well to meds, but they do not last long for me. But at least I respond to them.
I know I am pulling ya'll thread kinda off track, but it does help me to vent about the commercials. I mean... it is kinda like evnying them, because they did get such a better result than I, but I did at least get a result that was to my satisfaction, which was not hard to satisfy me because I was doing so bad, and anything was better than what I was like before. It did better than the oral meds, so was quite surprised by that, that is why I only have good things to say about Humira. It helped me when I needed it most. Now if it would have failed me... it would have been a different tune outta me.
one point though suzanne. remicade is an anti tnf just like humira and enbrel. it has a similar safety profile as the other 2 meds. remicade is not considered a bigger gun than the injectables beacuse it is an infusion. many people use it first because 1) it has a longer track record than the other 2 meds and 2) dosing is more flexible
[QUOTE=Linncn]I didn't mean you were slamming them. I meant some of posts that were joking about running up the stairs with laundry and riding bikes, stuff like that. I can do those things because of enbrel.
I don't know what i would do, I mean, MTX didn't work alone for me so I was never in the situation where I had to decide if I wanted to add enbrel just to prevent future damage. I needed it just so I could walk. I think that maybe I would take it just for that ( preventing future damage) reason though.
[/QUOTE]Sorry lost train of thought... anyways... maybe I will remember later. Darn kids running around screaming at each other.
Joonie, I thought you were joking about it because you thought it never really worked like it does in the commercials. I was just telling you that it did work that way for me. I sure hope your Remicade does the same for you. When Wanda finally calls with the good news. Maybe this week? Wouldn't it be great to be feeling better for Christmas
And I Miles2Go's post made me laugh because of the mental picture and then says "Screw the laundry". Sounds like something I would do. I get annoyed by not being able to do things I need to do very easily. I mean... it is sometimes a blow to your self-esteem when you have to get someone to help you open a bottle of water or even ask someone to help pull your pants up. It is a bummer, but I get over it for a while and move on and let it build up, then I "explode" again.
Yep, it sure will be nice when I call Wanda Monday and see if they came in yet, and she says yes. I will be just soo VERY happy.
Linncn - I thought it was just the 'scare tactic' in the advertising. If we jump in at the beginning, what do we have later? I'm probably not making sense.
Pip
Suzanne - thanks for this thread.
I personally still believe that medical doctors are clueless about RA, have no established protocols, don't know how to handle RA patients, and are complete corrupted by pharamceutical companies.
And that's my opinion.
Cathy
[QUOTE=buckeye]one point though suzanne. remicade is an anti tnf just like humira and enbrel. it has a similar safety profile as the other 2 meds. remicade is not considered a bigger gun than the injectables beacuse it is an infusion. many people use it first because 1) it has a longer track record than the other 2 meds and 2) dosing is more flexible
[/QUOTE]
I really thought about this, Buckeye, and I don't see it this way at all. 'Chemical to chemical', let's say, maybe a case could be made they are "just like" each other. But weekly injections you can adminster to yourself at home vs. IV infusions given at a medical facility add up to a very different set of risks, in my opinion.
Have a reaction to a med you inject weekly? Stop it, and it should be cleared by the time you would have had your next dose. When I liked the idea of Humira over Enbrel for my daughter, one reason being it was every two weeks and thus less shots, ped rheum set me straight - if she reacts, she will react twice as long.
Now, here is Diana, getting just six infusions a year. That is a long time, if something goes wrong.
All the drugs have risks, and the risks increase with bigger meds. Your risk of infection goes up simply from having an IV infusion, doesn't it? When my daughter had a PICC line, a fever meant she had to have a blood culture!!!!
That's just the way I see it. I had the ped's office give her the mtx injections, because I didn't want to (let's keep the needles at the drs. office, not at home). Imagine my surprise when it was crystal clear every week that the NURSES were very uncomfortable giving it to her!
Everybody does what they have to do manage their disease and nobody ever said it was easy, or that the decisions are easy. But what is presented in this print ad does not seem reasonable to me.
Pip...no, you make sense. I guess, for me anyway, it would hinge on whether it's true that MTX does not protect you from joint damage. But then, for me the q doesn't even come in to play because MTX alone doesn't control my RA.If mtx didn't protect you from joint damage, why take it? You could just take NSAIDS for pain and swelling, right? Good question, Suzanne. I wonder what would happen if I quit my MTX. According to my RD, they work together to control my symptoms but I've never been on Enbrel alone.But! My RD just raised my MTX because I was still having flares on the dosage I was on before. I'm at the highest dose of Enbrel so couldn't mess with that. He said I could add Arava but I didn't want to add another high power drug to the mix. So far I'm doing well. Havent had a flare in over 3 weeks now.I'm glad you are doing well. I don't think I would doubt that mtx works as what it is - a DMARD - for tons of people. That is what it so, so troubling to me - casting doubt about that for patients doing well on it alone.
Your situation is what is 'normal' - try mtx, not getting the results, add Enbrel. I'm just seeing more and more that seems geared toward targeting people doing okay on mtx, scaring them into thinking they need more.