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Quick question about starting Humira

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Posted 7/24/2010 1:37 PM (GMT 0)
I did a bit of a search on Humira but couldn't find what I was looking for so hopefully someone can answer my question.

I have been pulled off the clinical trial I was on due to an allergic reaction, and they offered me Infliximab or Humira. I decided to try Humira. I have had to go back on to pred for 6 weeks first. They explained that if the Humira doesn't work, I have one (or possibly 2, it is getting confusing) more drugs I can try (on the PBS) and if they all fail I can't have anything for 5yrs and my only option then if still unwell would be surgery. Anyways, he didn't tell me WHY I have had to go back on pred before I can start Humira. Being fairly new to all this but for suffering for so many years, I like to know everything that's happening and why. I had a horrid time with pred last time (developed steriod induced diabetes amongst other things) so I going back on to pred isn't something I take lightly (as I'm sure we all feel, it being such a fabulously awful drug VIEW IMAGE).

If anyone can just simply explain why it's necessary to be on the pred for 6 weeks prior to starting I would be extremely grateful.

Not sure if it's the same for all Countries, but I should state that I'm in Australia (I know there's a few of us here!).

Thanks for reading, hope you're all having a fabulous weekend so far. :)

Posted 7/24/2010 3:06 PM (GMT 0)
I don't know why your doc would tell you that you have to go on pred for 6 weeks first. I've been on humira for 2 years (and pred for over 20). I can only guess that maybe he wants to give you a boost of steroids to calm things down a bit so that it will give the humira a good chance to work. ??? If you start the humira and your disease is active it will be harder for it to get under control with the humira, but if you get on a short course of steroids to calm inflammation and then start the humira and THEN wean off the steroids it might give you a better chance of having the humira keep things quiet. That is my best educated guess. Have you thought about asking him what his intention is with the pred? Maybe it would give you better peace of mind to ask him. Pred is awful and no one wants to take it if they don't have to. Hang in there! I hope the humira works for you!!!
Posted 7/24/2010 11:20 PM (GMT 0)
Because these drugs are expensive and the government has set very stringent guidelines to restrict who can access these drugs.

Unfortunately, steroid treatment and three months of immunosuppressants are part of the preconditions, except in very unusual circumstances.

You can see the requirements here:

http://www.medicareaustralia.gov.au/provider/pbs/drugs1/files/4194-crohns-disease-adult-inital.pdf
As you'll see, they specify a six week tapered course of steroids. However, it might be possible to convince your doctor to prescribe (& fund!) entocort instead? You might have an easier time with that.

I hope this helps.

Ivy.
Posted 7/25/2010 1:51 AM (GMT 0)
I am thinking with your allergic reaction history, your doctor is trying to prevent that from happening with Humira, by using prednisone. Prednisone can help with allergies, or reactions in this way sometimes.

I have been on Humira almost a year now. I am now taking the stuff every week too. I have never had any allergic reactions to it at all. I have been on a low dose of prednisone this entire time, currently taking 15mg every other day.

Take Care
Posted 7/25/2010 2:19 AM (GMT 0)
Claudine: 

 Everyone pretty much has the right of it - prednisone is one of the best anti-inflammatories available with a strong ability to shut off your bodies allergic responses to medications as well inflammation that is part of this disease process.  Yea, there are a few pesky side effects to deal with but those improve when off pred.  Ivy has provided an important link that hopefully clarifys the direction your doctor wants you to go.  Studies unfortuantely, are quirky to be involved with just because they have to be rigorus about their study protocols inorder to have meaningful research that is useful in treating humans or changing practice protocols.    So best of luck, and personally, I like Entocort because of the minimal side effects of steroids.  I did gain a bit of weight but that has gotten better now and you will be happy to know that no family members have been buried in the backyard (roid rage -ya know!)  Take care, Barb

Posted 7/25/2010 2:50 AM (GMT 0)
hi there,
Everyone has already addressed the steroids question, but I just wanted to say that I used to have a HORRIBLE time with weight gain and pred, my blood sugars were all over the place and cravings galore. The last round of steroids I was derermined not to do that again so I did a low carb diet during the time of the steroids. My blood sugars were stable and I had no big cravings or appetite like I usually did. Pred can really screw up your insulin levels (making you ravenous) but doing low carb will inhibit the amount of insulin released. Just wanted to add that because pred can sound so rough and daunting but you can do it!!

PS Apparently going low sodium can control the moon face.
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