biologics-new question | Arthritis Information

 

Well now I'm getting the impression that these biologics are not the be all the RD's suggest they are. It sounds like initially people get great relief -then the pain comes back. Pshaw! I'm not even having great pain at this time.

Well, I've told you that I still do have occasional flares, even on the Enbrel and mtx.  And from what I can tell, I was in worse shape when I started the Enbrel than you are right now.  The best I can tell you is that for me, Enbrel made my life liveable again.  I don't remember the numbers, but my ESR and CRP were through the roof and now they are normal. After a year with RA, I have no erosion.  You, of course, have to make your own decision,  but as for me......I'm glad everyday that I made the choice I made.My RD told me I will always have a bit of discomfort, but unless inflammation and pain persist for several months I probably wouldn't get damage. I've never heard of having to be completely pain and discomfort free all the time in order to be considered controlled until lately.

Pain and discomfort free is certainly my goal, but I sure wouldn't go on biologics for the levels I have now.

It's definitely a personal decision, though.Honestly, my opinion after three years of trying drugs, whether biologic or not is that none of the them work really well. Most of them work for a time, as you say and then stop working. It's very individual, one drug or a combo may work for someone well for a while.

I don't think the biologics are necessarily better than the non biologics. It just seems that as a patient you are taken through the process of all of them hoping something will work and sometimes it is does for a while.

For me a combo of Plaquenil/Sulphazalazine/MTX had probably the best rest for me for about six months. Arava didn't work at all and sent me into a flare. Humira worked for about 2 weeks and from my last Rituxan round of six months, I got five good weeks. Yes, with Rituxan I went from 42 swollen joints to 4 for a short time but my bloodwork did not decrease that much - ESR was still 50 and C-reactive protein was 30ish from memory. Both have been lower than that at other times when I wasn't on biologics. Go figure!

Actually, I have found in taking probiotics in the last couple of months, generally my RA has been more settled in my opinion, just that I have felt better most of the time.

Is my goal to be pain free? No, probably not. My goal here, with the severity of my RA and what I deal with, is to be functional...that's all. I want to be able to enjoy life, take care of my daughter as a single parent, manage my household etc. Basic, simple things.

I don't think the biologics are a miracle solution, no more than the other drugs.
Visable inflammation right Gimpy? Or the kind that shows up in blood tests?Cordeila I think your RD is glamourizing the biologics by the sound of it. He's wrong. In my experience, it is simply not true. I wish it was true that MTX and biologics slow down or halt this disease.  I know tons of RAer's from here and other sites who are on a combo of MTX and a biologic and it is making very little difference to their disease.

I have actually asked my RD to consider taking me back to that non biologic combo of Plaquenil/Sulpha/MTX because it seemed to be the thing that has worked best.

I don't think one necessarily has to go have MTX and a biologic. Sometimes, a combo of  DMARDS alone will do the job. It is so individual, it is just what works best for you. If what you are on is working okay, biologic or not, stick with it. It's such a delicate balance, my idea is...don't muck it up. Lol.

All I say is everyone is different. 

That's completely true, Catnip. Everyone is different and responds differently to the medications. Also everyone's RA is different. This is a disease with many variables. Many of us experience similarities we can all relate too but in the end our RA and the medications are different experiences for each of us.  When I'm in the position of trying to make a decision about a drug or treatment plan I do some research and try to find the largest, most unbiased set of data I can to help me assess the odds that it will significantly help and the risks of side effects.  I also talk frankly with my doctor whom I trust to give me an honest opinion (...not that I always agree). Personally, I don't weigh very heavily opinions posted on a forum like this for the following reasons. 1) I think the people who come to a forum like this are not an unbiased cross section of the RA community.  Frankly, those who are doing well and happy with their treatment are less likely to seek the kind of support they find here.  Not a bad thing, but definitely a biased cross-section of opinions. 2) People with a negative experience with a drug or treatment plan tend to be more vocal about.  It's just human nature.  There's also a tendency not to "gloat" when you're doing well and others are struggling terribly.  You don't want to make them feel worse by talking about your success. 3) It's always very risky drawing conclusions from such a small sample...even if unbiased.  You're better off looking for studies with thousands of participants. [QUOTE=Alan]RA is a disease that flares and subsides...when it flares the Humira still helps but not as well.  It's not a perfect solution but I intend to take Cordelia's advice and "not muck it up".  Here's a link to a good summary article from last fall's ACR annual meeting.  I think you have to sign up for medscape access (free) to be able to view the article...not sure.  The conclusion is that most of the studies show pretty conclusively that early treatment with a combo dmard/biologic treatment does slow or halt progression of the disease...with at least some objective evidence from x-ray evaluations. Alan- I'm with catnip.. IF you don't try it.. you won't know that it works or doesn't.