After 12 months on Enbrel I started to get finger joint/wrist pain and minor swelling. Saw my rheumatologist and my labs showed my sed rate has increased from 20 (in Nov) to 60 (in March). CRP creeping up but still normal. Before starting Enbrel I was on MTX pills but couldn’t tolerate the nausea, so I’ve only taken Enbrel solo without MTX. It took about 2 months until I was feeling better so maybe I’ve had 9-10 good months. I was a little thrown off because before Enbrel most of my pain was in my sacroiliac joint but now I’m dealing with mostly finger joints and wrists.
We’re adding Otrexup (MTX) injections, titrating up for three weeks toward the full dose. Has anyone had good experience with adding MTX to Enbrel? If it is a good combo I don’t know how long I might have to wait to get relief. We’re running labs again in May.
I have good things to say about taking Mtx alongside Humira. At first I was dubious about the need to double up, but occasionally I miss out the Mtx for some reason and that’s usually when the PsA starts ramping up.
Rheumatologists do seem very keen to link Mtx with some (all?) biologics to prevent the body developing antibodies to the biologic. I think there may be other benefits too.
Hopefully Mtx injections will be much easier on you than the tablets. There was a time I took Mtx on its own. Although it didn’t provide the amazing relief that Humira has, it did help me considerably but at a very gradual pace. I’d say it took quite a few months to get up to maximum efficacy.
Certainly many Rheumy’s will do MTX alongside biologics, both in the hope of the compound effect, and for some biologics, there is good evidence that they can slow antibody formation to the biologic (though that hasn’t been well established for Enbrel as far as I understand).
I think it is really worth speaking to your Rheumy about the strategy - if Enbrel has stopped working for your arthritis, then taking Enbrel and MTX at the same time would seem to potentially expose you to both the positive and negative effects of MTX, but only potentially the negative effects of Enbrel, unless your Rheumy feels there is a synergistic relationship between them?
It’s a common strategy to start them together, or to start MTX, then if it doesn’t get the result you need, add Enbrel. I haven’t often seen it the other way around though. That doesn’t mean it won’t work - but I think it’s worth asking why, for example, you wouldn’t switch to Humira or similar and add MTX injections at the same time.
Hi! I was diagnosed in March of 2016 and have been through many different meds, including Enbrel and MXT. Nothing worked until my rheumy changed it up and put me on Cosyntex and MXT and I am sooooo happy he did. I am feeling almost “normal” for the first time in years! I have anemia (and other stuff) so I was put on daily folic acid, Celebrex, and antidepressants—it is all finally starting to come together. Hang in there—thanks for your post!
An update: my ESR increased on the MTX/Enbrel. Now I’m trying Humira. I did have a minor injection site reaction on the first one but nothing serious. Hope one day I get a good long run on these meds. This is a seriously high maintenance disease to have!