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Which one? Humira, Enbrel, or Remicade?

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Rheumatoid Arthritis
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Posted 10/19/2007 12:31 AM (GMT 0)
After about two years of positive arthritis results with methotrexate (and mixed results but a few good things from Prednisone, hydroxychloroquine, and celebrex), my left knee decided to have a disconcerting relapse.  Filled up with fluid again, after having been on MTX for all this time and every other afflicted joint is almost 100% (we won't talk about the various little side effects though like illnesses and acne!).

Anyhoo, the doctor says that we now need to concentrate on "saving the knee" and gave me a choice of medications and I have no idea which one to try.  I hate all medecines and I cry a little bit right before I take a new one for the first time because I had a really really really bad allergic reaction to a medication (proloprim) once when I was about 16 years old.

The medications are Humira, Enbrel (both injectibles) and Remicade (infusion).  I worry so much about side effects and want to know everyone's opinions/experiences with these.  Did one or another seem to supress your immune system more than another?  Did one or another seem to have worse side effects than another? 

The worst side effects I've had have been from Prednisone: severe and violent illnesses as a result of being immunosupressed.

Thanks in advance!

Posted 10/19/2007 1:18 AM (GMT 0)
hi leeloo, the way i was told to look at the choices was :
enbrel stays in your system 5 days and is a weekly shot
humira stays in 2 weeks so it is a shot every other week
remicade infusion you need to sit in an office or hospital for 3 hours or so every what 4-6 weeks i think, not certain on that one.
for me i chose the enbrel i hate the weekly shot and would rather do the every other week shot but i am in health care and see a lot of sick people and for me i didnt want something in my system for 2 weeks in case i would get sick on day 2 after my shot i have a better chance of gettin back on my feet than a low immune system for another 10 days. it was what my rhuemmy and i decided best to try first. we all hav different life demands so try and pick one that works best for your needs.

as far as side effects, i have none but then i dont have much to mtx either. actually i feel it on day 5 that i cant wait til i take my shot again as i feel like i begin to flair or feel inflammed

just before i take the next shot and if i wait any longer i do the penguin...prior post notation my shoulders feel like they cant stay by my side......lol

good luck! yally

Post Edited (yalinda) : 10/18/2007 7:17:34 PM (GMT-6)

Posted 10/19/2007 4:14 AM (GMT 0)
This has been my experience: 

I can only tell you that if those meds "take" with your body, then they typically make your life turn around for the postive! You may experience some minor cold/sinus type symptoms more regularly, but you'll feel so much better overall that a few sniffles won't bother you.

I would give them a shot (no pun intended!) and see how they work for you w/o worrying about the side effects. If they cause a problem, you'll know and can stop the drug. And, honestly, if one doesn't work that does NOT mean another won't - it's very likely one may work better than the other or one may not be the right drug for you, whereas another will work wonders!

From what I understand, most side-effects are not permanent problems. The few things they list as possible severe side-effects, as we discussed here before, are tpically side-effects people w/our issues are typically more prone to getting as it is....and there is no study to show if when taking the meds increase that risk or the numbers just reflect the standard ratio of people who get secondary diseases from the disease itself. Did that make sense?


I took remicade and had great results. I stopped becuase my immune system could not handle it after a while and I became too ill to take it anymore. Mind you, I've always had a weak consititution when it comes to fighting illness and methotrexate helped land me in the hospital on my death bed. So, I'm a bit of an unusual case in that matter I think. However, to make my point - in both cases, I (thankfully) recovered.

***

Posted 10/20/2007 1:24 PM (GMT 0)
HI

You are the first person I have been aware of being prescribed methotrexate and hydroxychloroquine. That is what the rheumatologist wanted to prescribe for me back when I had an inflammatory arthritis of the knee. He was sure I had IBD at that time but said if I 'sprouted" another joint he would start me on that. That may have been before Humira was approved for CD though. I never did develop another joint like the knee and that was 4 years ago. I'm not sure if he would suggest the same thing or not. I think what held him back then was the fact that I already run a low WBC count.
Posted 10/20/2007 1:27 PM (GMT 0)
Hi again:

Sorry, I was on the wrong board! I thought I clicked on the Crohn's forum. I finally realized when I read some other posts, all about methotrexate and plaquenil. Those drugs are not used that much with IBD these days DUH. Anyway, good luck with your treatment.
Posted 10/22/2007 2:50 AM (GMT 0)
Thanks all!

Enbrel seems to be the "oldest" of the two, and I like the small dosage idea too as it fits well with my completely founded fears about getting sick.

I just can't say enough about that the illnesses - when I was on Prednisone, after about the sixth month I seriously got sick about every two weeks. It was March '06 when I first got violenty ill and barfed all night (and for the first time in like seven years) and that was of course only a handful of days after I had started a new job! Then I would just get colds and sinus infections all the time and some sort of violent barfing illness whenever I didn't have a cold... In short I was constantly sick and would not only go from one illness to another, but they would overlap as well. I had practically no arthritis pain but it was still a high cost to pay!

I'm going in for my TB test tomorrow and will be telling the doctor which medication I have selected. Wednesday is my self-administration training.
Posted 10/24/2007 6:17 PM (GMT 0)
Hi leeloo67,
I have been on the Enbrel for 5 years...I have RA...and the Enbrel has been a miracle drug for me. Everybody reacts to it differently however, I have had no problems with it at all. Before the Enbrel, I could hardly move....my whole body was stiff, swollen and pain-filled like I couldn't even imagine. The thing with Enbrel is that if you have an infection, call your doc asap....you'll have to discontinue your enbrel for awhile. This happened to me only once. Wishing you the very best and please keep us updated. Take care,
Posted 10/31/2007 1:06 AM (GMT 0)
Hi leeloo67, am trying to decide whether to start enbrel, humira or remicade. Right now, I am physical therapy and feeling some minore relief. I have RA/Osteo and spinal stenosis. Diagnosed about 4 or 5 years. On methotrexate, prednisone, plaquenil, etc. My rheumy has me taking this physical therapy in hopes that it will relieve some of the constant back and hip pain. When I first went to him I had bursitis in both shoulders, both hips and could not even turn on a light switch without help. I was completely miserable. Had fibromyalgia also. After about two years trying different antiinflamatory drugs along with the metho., prednisone, etc., I finally began to feel better in my kneew, shoulders and hands. But, nothing seemed to give any relief to my back. I was on Bextra for a year or so and that seemed to help me the best and did not bother my stomach too much because I began taking nexium with it. But, they took it off the market because of the risk of heart attacks and/or storkes. Well, hello, all these drugs and the disease of arthritis puts at a higher risk for all that. I just wanted enough releif to be able to function - buy groceries, drive, turn on light switches, cook ,etc. I don't expect miracles.
If I wouldn't have these drugs I would literally not be able to walk right now, I truly believe.

My internist prescribed arthotec, an antiinflammatory that is supposed to have something to help with the stomach problems that some people get form these kinds of drugs. This is my last ditch effort, the pt and this new arthotec before I give up and go to enbrel/humira or remicade.

Am only mid 50's and wanted to leave myself something else to go to down the line. Don't know how long that will be, but do desperately want to be able to function as normally as possible.

After we consult with docs, take the meds, etc., we have to put it in God's hands. Hope you find the right drug and relief from all the pain. Can truly relate to your situation.
arthurmary
Posted 10/31/2007 3:40 AM (GMT 0)
I have chosen the Enbrel. I just "passed" the TB test and will be trained on how to inject myself on Monday!
Posted 11/6/2007 7:00 PM (GMT 0)
Well I injected myself with no trouble yesterday.  I wasn't worried about the needle at all just the medication really... but good news was that they gave me a very easy to use injection "pen" where you pretty much just place a big magic marker thing against your skin and hit the button.  You can feel the needle slide in of course but I'm sure all you fellow arthritis peeps know that the pinch of a needle is nothing compared to arthritis pain!  The injection site didn't even turn red or anything, and no immediate side effects have shown up.  Due to my experience with Prednisone I'm a bit worried about having a supressed immune system again.  So far so good - now I just hope my knee will unswell!

 

Posted 11/8/2007 12:49 PM (GMT 0)
Humira and Methotrexate have worked pretty well for me. At first the Humira wasn't working. We then upped the dosage to every week for about 5 months and then all of a sudden I started feeling better. It was very noticeable. Now I am back to every other week and am doing well, besides one set back with my shoulder which may or may not be related to RA.
Posted 11/9/2007 7:34 PM (GMT 0)
The doctor said it would take two weeks for the Enbrel to take effect, but here it is just a few days later and my knee is about 50% better. After having been swollen for about three months and the only relief provided was from pretty high doses of Prednisone, the knee is already 50% better. I can't believe it!
Posted 11/14/2007 4:48 PM (GMT 0)

Help !! I am in so much pain my body is so bad I can hardly walk. my body feels like I have been ran over by a big truck. I am on so many meds.and nothing helps I need to start taking Humira but I have bad teeth I'm on antibotics  the doc.says I can start taking Humira after 7 days. but I have to see a dentist. this is my first shot.I am taking methrotrexate.pridsone, for my r.a. I also have osto. ar. and osto pro.I have high blood and and high clst. sorry my spelling not good today. I am on 20 mg. of pridsone at this time I have been in criscis twice in the last 3 months . and that what is wrong at this time we only have one R.A. Spicalist in my city. not good he on vacation. didn't leave me any refills. I had to go to a walk in clinic.just to get them.I don't know what to do. I can't drive sometimes and I have no where to turn. I'm  going on Monday to see my primary care  dr. and talk to her and maybe she can take care of me. [email protected]

Posted 11/15/2007 11:53 AM (GMT 0)
welcome cranky jo. sorry to hear you are in so much pain. hopefully the doctors will get you on the right plan of care to help with your pain issues.
yes you have to be very careful with infections and many of our medications because they reduse our ability to fight off infections, i know i have held off taking my enbrel on several occassions feeling like a cold was setting in.
leeloo- good luck on the enbrel. i am doing well on it and i hope for the same for you! keep us posted on your progress!
~yally
Posted 11/25/2007 1:11 AM (GMT 0)
Enbrel update:

Three weeks in and almost all signs of arthritis are gone.

Three weeks in and today I have a wicked respiratory infection - spent all morning at the quick-med.  Started two days ago.  I hope it is just coincidence but this was the exact thing I was worried might happen...  Time will tell!

Posted 11/26/2007 1:28 AM (GMT 0)
hang in there leeloo.. it may just be that time of year.. how are you feeling?
Posted 11/27/2007 7:41 AM (GMT 0)
This is the first time that I have ever posted in the Arthritis section, but I saw the post and have experienced with most of the medications that are being discussed.  I have Crohn's disease and have been on Remicade for 3 years and on methtrexate injections for about 3 weeks.  Due to antibodies that I have built up toward the remicade, I am on an extremely high dose and frequency.  I have an infusion every 3-4 weeks at the max dosage of 10.  This has really been an amazing medication for me and I am really afraid that I won't be able to use it much longer.  Back in May, I briefly went on to Humira, but got o sick that that I was almost hospitalized.  Most doctors won't let you go back on remicade once you are off of it, but I am out of drug choices so my doctor decided to give it a try with 6-mp.  I have now added methotrexate at the prompting of my rheumy. 

  I would recommend Remicade to anyone that has severe arthritis or Crohn's disease.  I am not sure about how it affects someone with Rheumatoid Arthritis, as it is given in much smaller doses than IBD.  The side effects are not easy, but are so much better than pregnizone or even methotrexate>(So far for me).

Posted 11/28/2007 8:54 AM (GMT 0)

Good luck with the mtrxt addition. Supposedly, remicade works much better with the drug combo rather than solo.

***

Posted 12/2/2007 6:32 PM (GMT 0)
My infection was very very mild.  I went to the doctor ONLY because I was on the Enbrel.  I called my rheumy and she said to skip the Enbrel for a week.  I felt fine after three days.

Also, having skipped a week of Enbrel, I haven't noticed any backsliding in the arthritis department...

Posted 9/16/2009 3:58 AM (GMT 0)
I have been on mtxt for a few years as my RA got worse and worse. I decided on also taking enbrel and it made my body feel 100%. The only issue this summer was that I got a staph infection in my nose and something that looked like psoriasis on my face. My doc wonders if it is all from the enbrel. So now I am off enbrel. Has anyone else hand weird side effects like this?
Posted 9/21/2009 3:58 AM (GMT 0)
If all you have is RA I recommend the Enbrel. It worked very well for me till I was diagnosed with Crohne's. I'm now on Remicade and it doesn't work as well. I HATE THIS CRAP!!! Does anyone take fish oil or anything else to help???
Posted 3/28/2012 3:45 PM (GMT 0)
I have been taking remicade for pyoderma grangrenosum for several months now, and even with insurance, it's just gotten too expensive. After some online research, it seems that they also use Humira and Enbrel to treat it as well. I'm wondering if anyone has an idea how the prices compare to Remicade? Any chance they're more affordable? Any help would be greatly appreciated. Thanks!
Posted 3/29/2012 12:09 PM (GMT 0)
Most of these biologics are in the range of $1,500 - $2,000 per month. It all depends on your insurance, plus with Humira and Enbrel they have payment assistance programs to cover part or even most of your copay each month.
Posted 9/23/2013 8:11 PM (GMT 0)
Hi everyone,

I am new here but have a question. I have RA and have been on Humira and Leflunomide for 8 years. I was taken off methotrexate last year. I have been doing really well on these meds. The problem is that I am now on medicare and the Humira is going to be very expensive. My doctor has given me the option to change to Remicade as it is covered by my insurance. I am afraid to change medications because the Humira has worked so well. Has anyone changed from Humira to Remicade when the Humira was still working? Any advice would be greatly appreciated!
Posted 9/26/2013 2:27 AM (GMT 0)
Welcome SteiffTeddy,

You may want to make yourself a new Topic, as this thread is several years old. You may get more of a response.

I just wanted to let you know that Humira has a patient assistance card that will pay for a good portion of your copay. I only have a $24 copay with my insurance (one of the only reasons I stay at my job), but the manufacture pays all but $5 for me. I dont know how or if it would work with medicare but its worth making the call to find out if the med really works for you.

Good Luck!
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