Just had my assessment with a rheumatology nurse confirming arthritis not controlled, and eligible for ENBREL - and assuming T-spot test for TB will be negative should get first delivery of ENBREL in about 4 weeks. Have the video from ENBREL about how to give the injection, getting prefilled syringes and am basically to just get on with it (as I live quite far from the rheumatology centre, although they did suggest if I struggled that a nurse from GP practice might be able to help). Just wondered did other people continue their DMARDS when starting (am on sulphasalazine 1g twice a day and 15 mg methotrexate weekly). Will of course be checking with rheumatologist as to what he wants me to do, but interested to just hear about others' experience. So relieved that I am getting the chance to try something different.
It is quite normal to run a DMARD alongside a biological - it is thought to be more effective. Not heard of anyone running TWO DMARDS with a biological (I wait to be corrected!).
It is most often the case that Mtx will be continued while the biologic is added on - presuming that there was some benefit from the Mtx but just not enough. Keep in mind that each medication works in somewhat different pathways and is not a 100% replacement for another medication.
My doctor always keeps me on the methotrexate, with Enbrel and then with Humira, but that is all. It is just part of the routine.
Until recently, I was on Enbrel injections (50mg 2x/week), Methotrexate (17.5 mg weekly), and Sulfasalazine (500 mg 2x/day). Unfortunately, the combination has simply not been effective for me. This is not to say it will not be effective for you, as meds and med combinations work differently for different people. I will be switching to Remicade, and will continue the MTX and Sulfasalazine. I am waiting now for confirmation of my first infusion appointment, but have been off the Enbrel for about a month. Needless to say, my PsA and Psoriasis are completely out of control at the moment...hopefully I can get started with the Remicade soon, and it will work miracles!
You will do fine with the injections. They should have you do one in the office with them watching and guiding you. Once you have done one your struggle should be reduced. Keys to a comfortable injection of Enbrel are, warm the injection to body temp just before the inject by placing the syringe under your arm for 10 -15 minutes. Make sure that the Alcohol is dry at the time of injection. Hold the skin taught (so as you press the pen down to release the safety you do in get poked with the needle). Press the injector button and it will do the rest. It will put the needle in and remove it in about 15 seconds.
Everyone is different when it comes to their treatments. I take Methotrexate 0.8 ml injection per week and 50mg Enbrel injection per week. I also get a 100 mg corticosteroid injection about 3 to 5 times a year which helps me move. They hope that the Enbrel will reduce the need for these. But it is still like someone flips a switch when the corticosteroid injection wears off.
Be tough...you can do it.
I forgot that along with the Humira and the methotrexate comes the folic acid and the vitamin D supplement....
I started Humira this week. My rheumatologist told me to keep taking the Sulfasalazine and Plaquenil.