Chances of reaction with Humira or Orencia?

Realizing that all of the biologics are not perfect and that you can have a reaction to all of them, I'm wondering about something. I have to decide the next step in my journey of biologics.

I was on Enbrel for almost 2 years -- no problems with it other than it lost its effectiveness after I had a major dental infection. Switched to Remicade -- no problems for 1-1/2 years until this past week, when I had a doozy of a reaction. I never want to experience that again.

Humira is self-injected, Orencia is another infusion. I'm wondering if I'd be 'safer' starting with the Humira. Orencia is still too new and I'm not sure of its effectiveness yet for both RA & AS.

If I decide on the Humira, should I do my shots at the doctors office -- just in case (reaction)?

I'm confused, scared and could use some good advice here. I know we are all different and react to things differently, but we're all going thru this, one way or another.

I'm all ears...

Thanks.

~S.

Most medical practices prescribing Humira want the first injection to be instructed and supervised by someone on their staff. The reason is twofold: to make sure the patient has a clear uderstanding of how to do the injection and secondly to monitor the patient for a reaction. Being a licensed professional myself, my GI still wanted me to do my loading dose of Humira at his facility since I had some minor reactions to Remicade. I agreed with that reasoning. Since the loading dose I have given myself all my injections at home alone - noone around. I have not had any problems.

I have found I really ENJOY being able to do my Humira injections at home, free from the 1/2 day regime every 6 weeks at the infusion center to get Remicade. I agree with your thinking regarding Humira versa Orencia. Best wishes as you make your decision.

PS - Do you think your "chills" episodes during your [was it?] August infusion of Remicade was a sign of what was to come with your last violent reaction to Remicade? The scenario described was exactly what my GI was afraid was going to happen to me as each Remicade infusion started a worse series of post-infusion problems worse than the previous.

I take Imuran instead of MTX. My GI put me on that before all the AS stuff was diagnosed. My rheumy has mentioned MTX but I do like to have a glass of wine or cocktail from time to time. MTX is hard on the liver and in my opinion drinking while taking it is not a good idea.

BTW, I use the Humira pen and have NEVER had any discomfort from any of the injections. I leave it out for 30 minutes prior to injection. Then again, the PA that observed the loading dose series said I was the first person that had no complaints about some or alot of stinging with the pen.

Hey Ducky -- how are you doing? It's been a while since I've "seen" you; hope you're hanging in there.

Doctor's appointment moved to next Wednesday as my rheumy was sick. I can really feel the lack of Remicade/MTX in my body...everything is starting to hurt. I'm not a happy camper! Will let you know how things go - fingers crossed we decide on some sort of treatment plan soon!

~S.

Hey S. - Did you have your dr's appt? How did it go?

I saw my rheumy yesterday. We had a good long chat on everything that's happened, reviewed my blood tests, talked pain management (I'm past the manageable stage) and treatments.

I'm going with the Humira. Seems it's the best fit for me, for now, but we'll see. I'm losing patience with these diseases and the medicines we have to put up with. I'm staying on the MTX for the immediate future (rats), but at the same time, the MTX does help my RA in my hands immensely. I finally get to take my MTX shot tomorrow (who knew I'd be excited to inject neon yellow stuff into my belly...go figure).

My blood tests are fine; I was concerned about my liver and kidney tests, but they came back just fine. Naturally, I'm in a flare and hurt like heck and my sed rates and related tests came back normal (as always). I think those tests are a waste of time personally (for me anyway).

Ides, I'm so sorry.. sure it's not the flu or some other infection floating around? What options do you have to look into now? I feel for you... Oh, I talked to my doctor about the 2 prior infusions where I got really cold, he said it was probably a precursor to the violent reaction I had and I should've said something. He said I could have been pre-medicated before my infusions, or we could've stopped it back then, had he known. As I said before, live and learn.

So, Humira it is in the next couple of weeks. First shot (at my request and he agreed) will be at my rheumy's office - I have this abject fear of reactions now. I've requested the pre-filled syringe rather than the injectapen thingy. We'll see how it goes.

Nite all...

S~
No, not the flu. Definitely a serum sickness reaction to the protein in the Humira. Now on a quick taper of prednisone. I absolutely understand your losing patience with these diseases and the medicines we have to put up with. I feel the same way plus I am now quite fearful as to what the future holds. When I saw my rheumy on Tuesday, he looked at the tendons in my right knee [he uses ultrasound imaging to do that in his office]. A couple of them have pretty severe damage occuring from the Crohn's/AS. One has so much calcification at the insertion point he was amazed that I could walk as well as I do on it. He said I need medication to get the enthesitis under control, that the Humira was not doing the job. I have no clue what he and the GI will come up with considering my problem with the foreign proteins.

I hope the Humira really does the trick for you. Much relief from it!

Geez you guys.. sounds like you are both having a rough go of it.. Ides are you feeling better? ~S, when do you get your 1st Humira injection? Craig! Long to no see!

Hi,

Just reading and wondering, does anyone know if you can inject Mtx in the abdomen.  I've been injecting in the leg as this is where I inject insulin at times but would much rather use my stomach.  My Rheumy never said either way, I think he just figured that since I was diabetic I would know what to do.

Chow,

Raven

Hi Starrnr,
Quick question if you don't mind...I had my first Enbrel injection last week in the doc's office. Then came down with a nasty cold and had to go on a z-pack. Now that I'm starting to feel better and am finished with the antibiotics, time to do Enbrel #2. First one didn't hurt at all, used the auto-injector in my stomach..but kind of nervous to do it now. Any idea why yours hurt so badly?
Thanks,
Jody

Hi, I'm new to the forum but would like to respond to your question regarding Humira.  I've been on Humira for nearly two years doing my own injections (syringe) at home.  I've never had a bad reaction to it.  I moved to a different state and the ins co. there put me on Enbrel 4 X a month instead of the Humira which was not on their formulary and after 6 weeks I noticed hair loss.  They put me back on Humira and the hair loss continued although I'd never had the problem before the six wks of Enbrel. Other than the hair thinning & change in texture and occasionaly little red dots appear on my face.  Both are unpleasant but certainly worth tolerating in order to be nearly pain free although recently I notice less effectiveness and feeling more stiffness and soreness in my joints. At my last rhummy appt. she discussed the possibility of me changing to Remicade or Orencia but I'm scared to use either. Has anyone out there had the hair loss experience and also any suggestions on a good pill form medication to take along with the injections of Humira?  I'm currently on Lodine and it works just so so.  Thanks! 

Hello Erin and thanks for responding.  Yes, it does sound like we have similar scenarios.  It's nice to know that it isn't just me that has lost hair from being on Humira/Enbrel.  I have always had fine hair but a lot of it and now it is fine and not so much of it to the point that if I put it in a ponytail that the little tail isn't as big around as a dime...that's sad :(  I was very impressed with Humira up untill the past few months and now it seems as though it isn't doing as much for me. It used to be worth the hassle of getting it approved by my ins company and even dealing with the huge copays when none of the assistance programs will qualify me (any tips on that issue?) but when the quality of it medication becomes less and I'm headed to the point of almost needing a wig - it almost seems not worth the trouble.  I was previously on Arava and I must admit that in comparison to the effectiveness of the Humira these days I think I'd rather be on the Arava.  I checked with my ins company on the Remicade and I thought Humira was expensive but it's even more expensive plus I'm terrified of taking it. I'm open for any suggestions out there ;)  I appreciate conversation with you and look forward to talking to you again soon.  Thanks! 

PS. I forgot to add that I'm not on any pain medications so maybe my iodine level may not be as high as if I were, right?

Post Edited (Sunpuppy) : 12/20/2007 3:19:54 PM (GMT-7)

Yes, I'm on Lodine, guess I just wasn't putting it in the same category as pain pills like Vicodin, etc. I couldn't qualify for free

anything but yet can't afford the expensive cost involved.  It's not a good place to be when you're not rich enough to pay for the high cost to treat the RA but not poor enough to qualify for assistance.  Maybe I haven't tried to qualify with the right programs.  Tried the mfgr & a few others but got shot down pretty quickly.  Thanks for your advise, hope to talk to you again.