Enbrel wearing off after 3 or 4 days - anyone else have this happen?

The Enbrel has been working great for the last 4 months since I first started taking bIologics.

In the last month, particularly, however, I seem to be getting weekly flares that start about 3 or 4 days after the Enbrel. Not back to where I was, but definitely into survival mode.

Has anyone had this experience, and does it herald the biologic stopping working in another few months?

It as extremely difficult in Aus both to get on them and to switch them, so it is sensible for me to have a strategy in advance if it looks like it is required, so any advice is welcome :slight_smile:

I had this problem at about that point and I kept going since it really takes about six months for it to take full force. I have noticed an improvement.

Another suggestion is to ask your doctor if you can take 25 mg twice a week, this might help. ( I got this suggestion from a member, Andrew.)

About 6 mos in I had the same experience, we changed NSAIDS after a predi Burst went another year virtually"perfect", and then went to 50mg every 5 days. The results aren't as good as initially but more than acceptable will ride this on as long as possible (been over a year since the increase) as I plan on living a long time and don't plan on running out of bios.....

The average half-life of Enbrel is 122 hours. This means that the levels in your system will range from about 80mg just after taking a dose down to 30mg just before taking the next one. After 4 days the your level will be about 49mg. If you go on a 2x25 per week dosing your levels will vary between 63mg and 43mg keeping you more even throughout the week. In the US my insurance company is content to send me a prescription refill as long as it's been 22 days since the last refill. Therefore if I wanted I could go on a 25mg every 3 days, or even a bit less. On 25mg per 3 days, the average level won't drop below 52mg. This might be enough to stop the flares.

Enbrel may leave your system faster than average. If that's the case, then going to more frequent dosing will help you even more.

And so it is ilika! :) http://www.xeljanz.com/

It looks like it's approved for RA, it's not yet approved for PA. or psoriasis. :( I believe that's coming soon though! I bet we can still get into drug trials for it.

http://www.clinicaltrials.gov/ct2/results?term=tofacitinib&recr=Open

I don't see PA there... I'm not sure why it isn't. You can find trials for any drug on that website.

Here is the NPF's research pipeline. It's a few months out of date now.

http://psoriasis.org/research/drugs-in-development/pipeline

This has happened to me with various biologics. My dr. explained that some people process the medication more quickly, and that the "standard" dosage is something the drug co. has to pick for trials and approval. Not everyone will do well on that dosage.

As others have suggested, perhaps go to 2x / week at 25, vs. 1x /week at 50. When Enbrel first came out it was twice a week, and I did better on it than when it switched to once a week. I process meds very quickly. On Simponi, I needed to inject every 3 weeks, when standard dosage was every 4 weeks.

I have also heard of dr's going to 50 twice a week in rare instances. You can ask about that too.

Best wishes!

Thanks so much for the really useful information everyone.

I’ll give the 2 x 25mg a try if I can, whilst I’d love to try 50 every 5 days, there will be all sorts of complications - I might have to go in search of a new Rhuemy before I can get to that (ilikia’s first point is so right!).

I have been using Enbrel for about three weeks now. I have noticed a slight flare after 4-5 days. I was told that it takes a while to work well. I am hoping this doesn't happen to me.But thanks for the information so I will know that there are options if it does:)

Good info.