After 3 months on Methotrexate, with very little symptom relief and my RA apparantly still progressing, my Dr has decided that it isn't working completely for me - if at all - and so it is time for me to go on one of the biologics. Either Remicade, Humira or Enbrel. And my insurance has approved the change as well. So now I am stumped as it looks like the decison for which one of the three is on me... Oh yi yi!!! Of course I have read up on all of them and there are pros and cons for each one that is making it more difficult for me to decide. My Dr seemed to me to be slightly more inclined towards the Humira or Enbrel, although he really was non-committal. I am absolutely terrified of giving myself a shot which is the only thing that is making me lean towards anything and which would mean the Remicade.
I am very interested in hearing how anyone here has made this decison and why they have decided on what particular drug? I have to decide by YIKES tomorrow of all things!
Regards,
Melly
Melly, I opted for Humira. Liked the fact that it was every other week. The injections are quick, a lot less time consuming than going somewhere for the Remicade. Also I had reports of people having nausea afterwards.
Snoopy
My doctor originally gave me the same options. I choose Humira due to the fact that it was originally one injection every other week verses weekly or twice a week with Enbrel. I wasn't too hip on the self-injection either; but the infusions just seemed TOO serious to me.
They really aren't too bad. My husband did mine for me though.
I'm not on Humira anymore; but it worked well for me for two years.
Good luck with your decision. I know it's a hard one.
Melly, how much methotrexate are you on? I am in the same position as you are and expected to be discussing humira, enbrel, etc today at my appt. Instead, my rheumatologist increased my methotrexate from 4 pills to 6 pills once a week. He said the average dosage of methotrexate is 6 -8 pills/week. I moved up slowly due to side effects. Hi!! ive been on Humira for 2 years this october. I was also afraid of doing the shots, but it has been such a God sent that i dont mind anymore. My insurance wouldn't work well for the others, so my doctor selected Remicade. He said they are all the same it jsut depends on what works best for you. meI started on Enbrel, but after 3 months and not much change I was switched to Remicade. My dr said Remicade because the amount and frequency can be changed if it's not working well enough. Sitting 3 hours in the oncology dept at the hospital is a real drag, but I get to watch Comedy Central.My rheumie chose Humira for me...however my insurance wouldn't pay for it until I tried Enbril first. I have been injecting Enbril for 18 months. The first 2 injections were scary..but I am used to it. I figure when it stops working I can start Humira.
Good Luck
Thanks for speedy replies so far and will appreciate any others as well!
JuliahRA - Methotrexate-wise I have actually been on 8 pills per weeks now for the past 6 weeks after originally being on lower doses the previous months without improvement. Have to say though that I have not had any real negative long lasting side effects from the MTX - just slight nausea and fatigue the day after...
Regards,
Melly
Even after taking MTX for over 4 years I still get the nausea & fatigue; but it's been well worth it. I love it. I'm at 25mg now (10 a week)
I think I was at 17.5mg by the time we finally added Humira. My doctor suggested it before that though and I put it off. Hated to start it due to the fact that everytime I increased the MTX it pulled me through for a while longer. Evenutually he said "That's enough. We have to choose a biologic". So I did.
After 6 months on Humira I ended up going to weekly injections and got much better results than bi-weekly. Bi-Weekly is just a starting point; but lots of folks here are on weekly. It's not unusual at all.
The newer quick click pens make injections fairly easy. Don't let your fear of injections stop you from moving on with a biologic. You quickly get use to them. Although I understand how you might be leaning toward the infusions. My work schedule make those difficult for me though....that was another reason for my choice.
Melly, was on Enbrel for a year without much success but prior RD wouldn't prescribe MXT along with it. When I switched RDs he started me on MXT right away with only moderate improvement. The decision was made to try Remicade infusions and after adjusting the dosage of MXT and Remicade it's working wonderfully. I have no swelling, inflammation, or pain. I've been able to taper from 30 mg. of Pred to 7.5 mg.
I know that people say that going for infusions are bothersome but for me it's a chance to interact with other people who have the same diseases and are taking the same mix of meds. It's an unique opportunity to find out more about the disease process, talk with people who are in worse shape than you are, and sort of compare notes. For the most infusions we're all there about the same time. We bring our coffee and sit back, relax and chat. I think that most of us are starved for one on one information about the disease and meds. I don't know anyone that has RA. No family members and no friends with the disease. The only person I can talk with intelligently about the disease is my RD and his nurse. Even with having a supporting spouse there's only so much they know. I've learned a great deal and met some wonderful people at the infusion center.
I hope that your choice is good to you. Lindy
Lindy,
That is a very interesting perspective you have on the choice of Remicade. I hadn't even thought of that aspect and that really could have an impact for me as I live alone and don't have any friends or family with this disease that I can talk to. Hmmm... I did look at a video online of some sort of quick click delivery system for the Enbrel or Humira that would make them better as possible options because I wouldn't have to actually see the needle and/or push it manually into my skin....but the whole social thing you pointed out with the Remicade makes that very appealing to me...
Thanks again All!
Melly
Hi Mellie , my doctor recommended Enbrel since it has been around longer than Humira...My friend does remicade and loves it...I am only on week 2 so I really can't tell an improvement yet!. Good luck with your choice!It's a tough choice Mellie! My doctor offered me a choice between Enbrel and Humira. Remicade wasn't even mentioned. I ended up choosing Enbrel because I thought my insurance carrier would cover it easier--also, I like the fact that it's been around longer than Humira. I would like the injecting every two weeks with Humira though.