I had a rheumie visit yesterday. Quick version, started this process a year ago November, on Methotrexate 25 mg., Prednisone, 10 mg. Leucovorin 50 mg., Nifedipin 90 mg., folic acid 1 mg, calcium and vitamin D. I have Lupus/RA/Sjogrens.
Anyway - Although I'm a lot better than I was a year ago, I'm far from "myself". I doubt I'll ever get to the old me, but this me isn't quite good enough. So, he wants to add in another drug. He gave me a brochure, told me to read about the choices, call him in a month. (I boosted MTX from 20 to 25 two months ago, feel better since then so we are going to give it one more month to see if it gets any better, if it doesn't, then add in something)
So here are the choices...I can start with another pill, Arava, or go to Enbrel or Humira. Any suggestions? I know what works for one, doesn't for another, but has anyone been successful with Arava? Chicken sh*t that I am, I'd like to put off jamming a needle in my stomach if possible.
Of course I'd keep on all the other meds, but the hope is to taper down on prednisone. I've tried the 5, 10, 5 dose on that and haven't been successful. The days I need to take 10, I'm so stiff, etc.
Sorry for the long post, I'm really confused with this. Any suggestions would be great.
Hi Debra, I have been on arava now for over a year. At first it was fantastic, I felt more normal than I had in years plus no side effects like the methotrexate did. But about 5 months ago the pain and fatigue started to increase again so I started on enbrel. My miracle drug. The fatigue lifted the same day as my first shot and I have been able to things I never thought I would again. The needle doesnt hurt at all and is so worth it,to have a life back. I still take arava, and at my last rheumy appt she added plaquenil to the list to cover the bits that were still giving me trouble. If I was you I would definately give arava a go before adding enbrel as it could work longer for you than it did me. All the best with whatever you decide. AllyDeb, I take 25 MTX, but I take it by injection. My RD said when you get to that high a dose your body doesn't absorb all it by mouth. I also take enbrel. I use the sure click pen, and although there is a bit of stinging, it really isn't bad a t all. And I HATE shots, can't believe I am now taking two every week. But such is life.
Anyway, the enbrel MTX combo works pretty well for me. Hope whatever your choice is brings you back to normal
I just started Enbrel. Had my 2nd shot last Thursday. I was terrified of giving myself a shot but it wasn't bad at all, just some stinging towards the end of the shot. Don't let the fact that Enbrel is an injectable deter you from trying it.
I say take the plunge...so to speak...and try the Enbrel or Humira. I take Arava and Humira now. The Arava helps fill in the gaps, but it's the Humira that provides most of my relief from the RA symptoms. The injection is really no big deal, the needle is very thin and doesn't really hurt at all...the med does sting as it goes in but that only lasts a few seconds. Anything that would help you get off the pred is worth a try.
Alan
Debra, It sounds like you need to start either Enbrel or Humira so that you can taper off the Pred. When I started biologics I was on 35mg. of Pred. Have tapered to 5.5mg and will be on this amount indefinately. Also, you may be able to reduce MXT from 25mg. You're taking the max MXT now. I skipped Arava and went straight to Humira. RD. did put me on Sulfasalzine. Good luck with whatever choice you make. LindyDebrakay,
Have been on Enbrel for 7 out of 8 years and found it to be great! Had immediate relief after the first injection! The last year it just hasn't worked as well, so RA doctor added Methotrexate (15 mg) last week. Still staying on Enbrel. You're right.....these drugs work differently for everyone. Don't be afraid of the shot....it's so simple, a very thin, short needle and it's over quickly. For me, it was a God-send. Good luck with the decision making...I know it's enough to drive one crazy. I just went through it myself when trying to decide whether to add Methotrexate or Arava. Guess there's no way to know for sure without trying. Sharon