Need a little input | Arthritis Information

 

Ok ladies, I am now is uncharted waters for me and would love some input from you guys. My doc says the methotrexate with Plaquenil combination is not working. She says my blood tests are still remarkably high, that I have a severe case and that this particular combination rarely works on individuals with severe RA. So, she wants to switch me to the shots and says that I can choose which one I would like to go to. This is where I need you guys. I have read about them all Enbrel, Remicaide, Humira, etc, but with all the warnings out there on all these, I would really like some feedback as to which ones you take, ones you have had issues with, side effects, etc. I would really appreciate ANY help you can give me as I am SO lost. Thanks!Schell, you usually work the med ladder.  The usual course is to start Enbrel and MXT.  If no relief then onto Humira and MXT and then onto Remicade and MXT.  You'll hear all kind of stories.  Everyone reacts differently but for the most part I think that Enbrel is the next step for most people.  I went from AP to MXT, to Enbrel, to Enbrel & MXT, to Humira & MXT, to Remicade and then back to Humira and an increase in MXT and added Sulfasalazine.  I'm in clinical remission.   I also was diagnosed severe but I was in the severe state for 5 years.  Try and get it under control or in clinical remission as soon as possible.  Lindy That is interesting Lin. Wonder why she sent me away to research each one, giving me option of which to go to..hmm. My mom stopped breathing with Remicaide, so I worry about that one, but the others I have never heard anything about. It is all so new and the warnings on all them make me skittish of course!Schell, Not all RDs treat the same way.  That's been apparent after reading posts on this forum for the last couple of years.  Maybe the ladder has to do with when they were approved for use.  Enbrel was the first approved, then Humira and shortly afterward Remicade.  I don't have a scientific answer for you.  Maybe someone else knows why your RD would give you a choice.  I can understand giving you a choice between Enbrel and Humira.  I've never had a reaction to any of the dmards or biologics.  Have had a couple of sinus infections and a UTI and that's been it.  No colds, no skin infections, etc.  LindySchell, I have only taken Enbrel (with mtx).  I take 50 mg once a week in the Sureclick shot.  It worked for me literally overnight.  I don't think that's the most common response though.  I was just lucky I guess. I have no side effects other than a red itchy patch at the shot site that lasts for a few days.  Enbrel took me from being a virtual invalid to back to pretty much normal.  I still do have the occasional flare though.  Good luck.Schell,

That makes sense Lin. Kween..it gives me hope that you were taken off the methotrexate. I know most don't but my body hates it. I wake up feeling like crud the next day, so if I can drop it and just use the Plaquenil with it, that would be great I don't take any pain meds, although there are days! I try and stay away from them all together, since my mom was addicted to them at one point. I do however take prednisone every day. When I stop taking it, the pain that is already bad becomes unbearable. I can't sleep at night at all without it at this point. I would like to get off it all together. For whatever reason my RD has absolutely no preference over me starting on Enbrel or Humira. He says it's my choice.

kweenb- I must have been sending you telepathic messages...I've been wondering where you have been.

How did you decide to discontinue the MTX once on Enbrel and did you have to taper it? What was the taper schedule like if so.
My RD gave me the choice of Enbrel or Humira, and I chose Humira simply because I only have to inject myself every other week. I almost chose Enbrel because my sister takes it, and has been in clinical remission for over four years. However, Humira has put me into remission also, so, I'm very happy with my choice.
I've been on Enbrel with oral MTX and then Humira with MTX injections. Honestly I couldn't really tell anything helped. When I got vasculitis they took me off all my RA meds because they couldn't figure out why I had it and thought the medications might have something to do with it. I was on Humira for almost a year, now when I read all the side effects that it can cause, I'm glad I'm no longer taking it. I've never used a biologic, but just wanted to wish you the best of luck with whichever one you choose. I was on Enbrel for a couple months with no relief, which was when my PCP threw up his hands and sent me to another dr., she put me on Remicade. Since your mother had Remicade, then you must know you have to have it either in a RD's office or a hospital. I would start with the ones you can do yourself first. I skipped Humera because the Remicade can be increased in frequency and amount, if a lower dose doesn't work. Good luck with your choice and I hope whichever you choose works for you. What is your mom on now?Different RDs definitely approach things differently.  Mine gave me all the biologic literature and told me to pick one.  I chose Remicade for the office infusion method -- I detested giving myself the MTX injections, so it was an easy pick.

Best of luck with whichever you choose.
Thanks so much ladies. I think the answer is..there is no one answer. My mom is not on anything right now. She is very scared at this point, but she has a mild/moderate case, so she says she can handle the pain for now.

I hate giving myself shots too, Joy. I am not particularly crazy about infusion either though. I say that the whole disease sucks, but then again, I can't see anyone here arguing that point. *snicker* We are all in the same boat! I am just so glad there is a website like this out here so that we may pick each other's brain.

If it gets me off the prednisone and puts me back into my children's life, I am all for it! The side effects are scary though! I agree![QUOTE=wanttobeRAfree]For whatever reason my RD has absolutely no preference over me starting on Enbrel or Humira. He says it's my choice.

kweenb- I must have been sending you telepathic messages...I've been wondering where you have been.

How did you decide to discontinue the MTX once on Enbrel and did you have to taper it? What was the taper schedule like if so.
[/QUOTE] kweenb

I have just increased to 20 mgs MTX per week and my pred has been increased to 10 mgs per day. My fatigue is high. I have some really good days- like three a week; followed by achy and stiff days. It's like my doctor said- I don't think you are going to get the result you are looking for by increasing the MTX to the max. dose.  It's only been 2 weeks so I am giving it more time but in my gut...I think when I go back for my April appt. I am going to start a biologic. However...I am now feeling out mono therapy with a biologic. He seems to think MTX and a biologic is my ticket. Since he was right this time- I should probably just listen to him.
wanttobeRAfree2009-03-15 17:44:59
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