Enbrel vs. Humira | Arthritis Information

 

For those of you on biologics- it seems the majority are on Enbrel.

hi wannabe from what i read the anitnfs have the same potential side effets.
when i thought i was going to get one. i chose humira simply because it was
pen inject.. i found the more i researched the more different aspects to the meds
and it became more confusing..
Boney
Hi Boney- Hi I know that when I was on Enbrel, it was because that is what insurance agreed to first. Then Humira....then Remicade...and now Orencia. I was on Enbrel for a few years and last fall my RD wanted me to try I was on Enbrel first and for me it was literally a coin flip.. Enbrel worked wonderfully for 16 weeks, then just pooped out.. I went onto Humira, which also worked for 16 weeks, but never quite as well as Enbrell.   Now I'm on Remicade, and it also never worked as well as either, but its chugging along, working well enough.My doc said it's a 50/50 with results.  He gave me the option, they both have pen injections which are easy, but one was once a week, one was every other.  I chose the every other, so humira.In AU choosing between anti TNF's is not an option. How it works here is that when you are dxed your rheumy will start you on an appropriate DMARD. They start with Plaquenil often as it is the mildest and has the least side effects, then possibly sulphazalazine, then MTX, Arava. You are taken through all the non biologics first in a way your Rheumy thinks is appropriate. If they don't work you are moved unto the next thing that is an option. When the question of biologics come up, first you have to qualify for them by being on Arava for three months and it failing. They apply to the government for a biologic to be approved, usually Humira is first. Why? I am not really sure. I think it is thought of as the most user-friendly biologic. If Humira fails then possibly you will then be taken to Remicade or Enbrel. With me on went on Humira and it worked but then the side effects from it were repeated respiratory infections. My rheumy believed at that point, I had become immune to the biologics so Enbrel and Remicade were never an option for me. If I was immune to Humira, I was immune to all of them. From there he took me to Rituxan and if it fails the only one left that I haven't tried is Orencia.

Having a choice about which biologic is just not an option in Australia.

I know some people are particularly prone to being allergic to medications but in trying pretty much everything except Orencia, my experience has been that I have had very few side effects on the whole. Some hair loss and breakage, the respiratory infections with the Humira...not a lot else.

I think it is easy to get caught up in possible side effects. You could worry yourself to death over the remote possibility of lung cancer from Humira and then get pancreatic cancer and die anyway. Each medication has a long list of 'possible' side effects. They have to put down all likely side effects but the reality is often you don't get any of them. Don't twist yourself in knots about this, if you actually have a choice about which biologic then go with what your RD recommends plus what your instincts tell you is right for you.
Here is my understanding, as explained by a real dr. to a confused mom:

Enbrel is hamster (made in the ovaries of Chinese hamsters), Humira is human, Remicade is mice (something about human DNA with mice DNA twisted in at the tail?).

Enbrel weekly, stings.  Humira every two weeks, really stings; if you react it takes twice as long to get it out of you.  Remicade is infusion.

The latest I'm told is that Humira is being shown to work better, but I don't know if that meant specifically peds or for everybody.
I was given my choice.  I opted out of remicade first because of infusions were during the week and I miss enough work from Dr appointments and testing.  I liked the thought of enbrel even though the shots were weekly.  I take the MTX weekly.. and this just follows that pattern?  Makes no sense i know..  It seemed to be the one w/ the least adversity from what I've read.  I have no idea how they select what you need.  From the first appointment my RD was determined I was or should try Humira.  For my insurance to cover it, I had to take MTHX for 6 months and had to prove it was not enough meds.  Then after 6 months, he said let's try it.  I never thought my insurance would cover it, but they did and do.  I have been taking the Humira for just about 3 years -- in Nov. it will be 3 years.  I am wondering myself if it is still working--as I seem to be experiencing more pain lately in my joints.  The last time at the RD he said my numbers were extremely good--so who knows.  He ordered more x-rays but I have not had then done yet.  Unfortn. they only do them 9-5 M-F--my working hours and they are across town--construction, gas prices, etc.  I guess it is the "usual route" all RDs seem to use.  One thing--with Humira, Embrel, etc. you pay a co-pay.  With the infusion, I understand there is no co-pay.   I was given the choice between the two and I picked humira because the shots were bi-weekly and it was cheaper. I did take it for 8 months and at first it seemed to work but then didn't. I started with new joints bothering me and so dr put me on enbrel. I felt great after the first shot and been doing really well. My blood tests were normal and I had energy! Now I don't think it's working that well. I started having knee pain and stiffness and never, never, ever, had problems with my knees before. I go to rd on Thursday and am anxious. I am so mad because he took me off vicodin and told nurse to tell me I shouldn't be in that much pain. Which I don't know how he knows because he's not in my body and I haven't seen him for 3 months! Yeah, I have lots of things to discuss on Thursday, like whether or not he will continue being my dr. I haven't had any xray, mri's or scans since I have been seeing him. It's been almost 3 years. So to hog your post, I will start a new one and find out how often people are given xrays and mri. [QUOTE=Cordelia]They apply to the government for a biologic to be approved, usually Humira is first. Why? I am not really sure. I think it is thought of as the most user-friendly biologic.

Having a choice about which biologic is just not an option in Australia.
[/QUOTE]Actually Cords, I was offered either Embrel or Humira.
I chose Humira because it is once a fortnight.
She pushed to go straight to Embrel, infact if I had not bought up Humira then she was going straight to the other.

I havent started the stuff yet, still waiting for clearance from who ever it is that OK's these things.

Just my very limited experience.
Stephen, it's very much about the RD and what they prefer. Humira seems often to be the starter biologic it seems. Regardless, of which one in AU they have to have special government authority etc and your RD has to write reports to justify your use of it and they have guidelines they have to report back on to show that you need it but that it is also working.

All the Humira approvals come out of a special Medicare department based in Hobart, Tasmania. That is all that particular office do, is deal with Humira. You will be sent a prescription in the mail, Stephen. It can take up to a month after your RD puts the application in for it to be approved and for you to receive the first prescription. You then get it filled, check that you pharmacist keeps it in stock and doesn't have to special order it. You should then go back to your RD's office and be shown how to use it by someone, they is often what happens. Oh, it's wise to note also that ONLY your RD can write a Humira prescription. Your GP can't and the prescription can only come through the office in Tasmania and out to you in the mail.

Honestly, I don't really think it matters which biologic you choose...if you have to go to biologics then pick what suits you best at the time. Humira being fortnightly instead of weekly is often why people choose it. Who wants to jab themselves any more than they have too. Thanks for the infill on how it all works...
As for showing me, she already has and made me go thu some dry runs with all the gear.
And gee whiz, you even get a bag, videos and literature.
Got all that lot, just need the prescription.

She did say that I would or should get a script for two or three months in the first lot, not sure just how many months but I don't see her untill  the 27th of June.
I am currently on Humira and have been on it for the last 2 years. My doctor started me on this immediately as soon as I was diagnosed. I don't know why she choose that but I was not functioning at all and I was so new to all of it. I was completely fatigue and in alot of pain. The Humira has helped me alot but lately pain is starting back up and I am also running low grade fevers a couple days before I am due for a shot.

 

I also didn't have any insurance problem they just approved the Humira but my co-pay is killing me.

 

Renee

I take Humira and was given a choice of three in the beginning. Like the other's who choose Humira the every other week shot sounded much better to me than Enbrel. My RD's office is about 45 minutes away and I thought the infusions would cause me to miss too much work (And honestly they just sound so much more serious; they aren't really....but they just sound that way, don't they?). After being on Humira for 6 months I switched to taking Humira weekly. I had really good results with it for 2 years.

 

My doctor took me off of Humira after experiencing some neruological symptoms and there's that fear of MS or simular problems they warn about. We stopped the Humira to see if the symptoms stopped. They didn't. He sent me to a neruologist. Long story short; he helped me with my problems and determined that it wasn't the Humira causing my problems so after being off Humira for a year I'm now back on it again at every two weeks. Hopefully I can stay at every two weeks instead of every week because I hate, hate, hate the injections. Even with the quick pens they really do hurt and I hate them; but they help enough to put up with it.  

 

I think we all sort of react differently to the biologics and you won't really know until you actually try one.

 

I don't understand why so many of you get the run around with getting approval for these meds. My doctor prescribed it and they called me before I got home to schedule delivery. I experienced no waiting time at all. Mine are delivered by a speciality pharmacy in the next town. They ship it to the office. It's so easy.

 

Renee~Ask your doctor's office is they have any Co-Pay assistant cards from Humira. SInce you've been on it a while you might not be able to get it but you might just ask. When I was using it those first two years my co-pay was . When they called to set up delivery this time they said the co-pay was going to be 0! I said YICKS! That's more than twice what I was paying before. They told me about the co-pay assistance cards from Humira. They pay 100% of my co pay for the first 6 months and then 50% of the co-pay for 6 months after that. You might also want to ask your doctor about weekly injections. It might make a big difference and the co-pay won't be any difference because it's based on a per month dose not the number of injections you get. It's worth looking into.

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