A tale of two drugs | Arthritis Information

"It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of Light, it was the season of Darkness, it was the spring of hope, it was the winter of despair..." (trivia question: name of book and author for above quote...no googling!)

A perfect metaphor for my experience with RA the last month or so. I have been doing quite well on Humira for 2 and a half years now. About a month ago, a huge flare started. It began in my knees, which have not been a problem for the 6 years I've had RA. My knees swelled quite dramatically and were very painful and stiff. The swelling slowly moved down my legs to my ankles and feet...getting up and walking each morning was quite a chore. My walks with Joey became shorter and shorter, but took the same amount of time so he didn't seem to care too much. My shoulders flared next making it very difficult to sleep. I got up pretty much every hour and moved around some to try to loosen up a bit. I finally went to my RD two weeks ago (...and again last week...and again in 3 weeks). She was not happy...said I looked terrible. My blood tests showed anemia and all the inflammation markers were very high. So...she switched me to Enbrel and added Diclofenac (an NSAID). The Diclofenac helped a little...nothing dramatic. My first Enbrel injection was last Wednesday. Within 24 hrs I felt about 80% better and it has slowly improved even more since then. It really is quite remarkable! It's amazing to me how quickly the Humira lost effectiveness and how quickly the Enbrel kicked in...anyone else experience something similar? I'm pretty much back to normal...my next Enbrel injection is this Wednesday since I take it weekly.

Alan

Alan2008-10-06 17:14:46Correct...hmm, come to San Francisco on Dec 6th and I'll provide a free ticket to our next concert (San Francisco Mandolin Orchestra)!

It was difficult to make the change...Humira has been very good to me for a long time.

Alan

Hi Alan, happy that you posted. I had Remicade fail quickly and I went to the RD as soon as I felt the flare starting. I had to wait for a few weeks to start Humira but once I started I felt the flare lessoning and within 2 weeks I was back to where I was when Remicade was working. Since then I've achieved clinical remission with Humira, MXT, Sulfasalazine and hopefully I'll stay in remission for awhile. It's wonderful that Enbrel started to work so quickly and you can get back to making beautiful music again. LindyHi Alan, I am glad the enbrel is working and quickly, too. I took humira for 8 months and it worked somewhat but in that 8th month, I had a huge flare and it went all over. To my hips, knees and places I never had problems before. My shoulder too. Dr put me on enbrel and I felt so much better after just one shot. I have been on it for 10 months and it continues to work well. I take my shot on Tuesday. By Sunday I can feel it wearing off and I look forward to.

I wish you the best and continued good days!

I think there's an important lesson here. If you have had good success with a TNF-inhibitor and it fails it certainly is worth the effort to try another before moving on to something else. I wonder if your body looses its ability to block the action of the drug after a while and you could go back to the drug that failed...might be worth trying before moving on to Orencia or Rituxin...anybody ever try it???

Thanks for the kind words!

Alan

**forgot to knock on wood**

**knock, knock, knock**

another knock for you too!!

Great to hear you are responding so well. Hope it keeps working for a long time.

Alan, when I started Humira after Remicade failed, it wasn't the first time that I had tried Humira.

The first time I tried it was with another RD and he was reluctant to increase MXT to help Humira and talked me into trying Enbrel which never did much. My new RD increased MXT along with Enbrel and it worked pretty well for about a year. We decided together that I wanted clinical remission and not just to feel somwhat better. Went BACK to Humira with an increase in MXT and added Sulfasalazine and that's my miracle drug combo.

It's possible to go back to drug that you've tried before or skipped and have it work well. I didn't want to go on to the other drugs until I knew positively that none of the others were going to work. Sometimes you just have to keep searching for the right combination. It's not an easy process. Lindy

Alan - glad its working so well for you, and I have missed your poetry, but prose is good too :)Hi Alan, good to meet you. I'm fairly new around here.

Glad to hear of your succesful switch and that you are back to living a normal life.

I'm also glad to hear that switching from one TNF to another truly can make a difference. Remicade just bit the dust for me and I am awaiting insurance info on Humira and Enbrel in order to choose my poison. I have been questioning why the doc would think a new TNF would work when one is failing, but looks like you gave me my answer. Sounds like it worked wonderfully for you.

Enjoy your new found movement!