You know I am still learning so much about Psa, even though having psoriasis for so many years, this part is still very New. Flares a you all call it I always attributed to aging. However, since going to the Remy and starting MTX and Humira but only 2 injections into the Humira. I am still having tough times with pain (flare UPS). Do y you still have flare UPS even while on biologics? Sorry I am so dumb about all this. It’s just new way of seeing it all. And what are SI joints please?
And how long do flare UPS usually last while on biologic?
No question is dumb here. Flares last different amounts of time for different patients. I did not really understand the term "flare" until I was given prednisone. During the taper I had the worst flare of my life. I get it now and do not take prednisone ever. My flares have all been stiffness, pain and fatigue that is greater than usual. It appears suddenly without a known reason at times and goes away either quickly or not but usually the reason it it recedes is not readily apparent either. I know stress is a huge trigger for me. I do not have any food triggers. The medications I take metotrexate or mtx and Remicade and naproxen greatly reduce the number and severity of the flares I get. Since I was not diagnosed for 30-50 years it took quite a while to get my PsA under control. But look how long it took me to get there! All the meds take a long time to see results usually 4-6 months. There are lots of things to make you more comfortable during the time it takes the meds to work: Tylenol, non-steroidal anti-inflammatories or NASIDs, soaks in hot tubs with or without Epsom salts, topical salves and patches, just to name a few. There are lots of ideas in previous discussions. SI, one of the big places for PsA pain is sacral illiac joint. I think of it as the the lower part of your back, above your butt about where the dimples are. The other place we seem to all have pain is the achillies tendon at the heel. A lot of pain is tendon pain and is easier to treat as it responds well to the things we are able to do ourselves- the salves, rubs, patches, soaking, splints, etc. The longer i am on a biologic the quicker my flares resolve and the fewer I have.
Humira cause flares in approximately 10% of it’s users (approximately the same for all biologics). However, two shots isn’t enough to determine that. The number one reason biologics fail is because people don’t see incremental results in rather short period of time. The results of the drug are not linear; so result should come around 3 - 4 months and plateau around 6. If you don’t see results by the 4 month it’s time to try something new.
The time to response for the biologics really does vary - Enbrel was overnight the first time I took it, but Humira takes significantly longer for me (and I'm pretty sure I'm not typical - you don't hear too many reporting an overnight effect). Even saying that - the time it took for me to get the best control out of Enbrel was closer to 4-6 months (I went waterskiing that day - I still remember it!). I'm still learning with Humira.
Can you believe even different conditions in the same person take a different length of time / number of shots to improve? - I had to go off my Humira for a while because my daughter's kindy had a kid with chicken pox. About a 1.5 weeks after the first injection back on it, my arthritis was broadly under control. My IBD, still getting worse. It's going to take a few more injections for that to sort out...but the point being it really is individual.
Certainly, you may still have flares from time to time. I know I do, though as Michael says, the are nowhere near as severe, and shorter in duration. I even had a patch of time (about 1 month) on Enbrel where both myself and my Rhuemy wondered if it was losing efficacy, as I kept getting the inflammation and pain returning 3-4 days after the (weekly) shot. Turns out it was an underlying flare - and after a month, just disappeared by itself for no reason.
It is possible that you won't respond to Humira. I can't remember the figures exactly, but I seem to recall that something like about 33% of people don't. As mataribot says though, it's really to early to be sure of that yet. If and when that happens, we are all blessed to have lots of other options to try, and in the meantime, those suggestions by michael sound rather soothing :)
Well, like I said after psoriasis for 40 plus years and just now really beginning to get answers I feel dumb. I hesitate to all for fear of coming across add ignorant. I waited so long due to the fact all these harder years I had no insurance, now I have had the past 2 years and took me well over a year to get a diagnosis. Do I am learning now. I was also so busy taking care of my late husbands the last 12 years of his life I let my pain and fatigue go, even dismissed it as being an only caregiver to him and just exhaustion and the stress of it. I appreciate all your time and answers.
Not a problem. There are a few of us old timers who enjoy answering questions and spreading around some of the knowledge from others who helped us when were new at this too. There is a huge learning curve to all of this. Give it time. You will learn, whither you want to our not! We are stuck with PsA (psoriatic arthritis) so we learn. Unfortunately all auto immune disease therapies are in their infancy. The doctors are just now learning about them. So we are all learning along with them.
Jen what is IBD? Please I am not quite up to par on the terminology of the disease as of yet.
Jen said:
The time to response for the biologics really does vary - Enbrel was overnight the first time I took it, but Humira takes significantly longer for me (and I'm pretty sure I'm not typical - you don't hear too many reporting an overnight effect). Even saying that - the time it took for me to get the best control out of Enbrel was closer to 4-6 months (I went waterskiing that day - I still remember it!). I'm still learning with Humira.
Can you believe even different conditions in the same person take a different length of time / number of shots to improve? - I had to go off my Humira for a while because my daughter's kindy had a kid with chicken pox. About a 1.5 weeks after the first injection back on it, my arthritis was broadly under control. My IBD, still getting worse. It's going to take a few more injections for that to sort out...but the point being it really is individual.
Certainly, you may still have flares from time to time. I know I do, though as Michael says, the are nowhere near as severe, and shorter in duration. I even had a patch of time (about 1 month) on Enbrel where both myself and my Rhuemy wondered if it was losing efficacy, as I kept getting the inflammation and pain returning 3-4 days after the (weekly) shot. Turns out it was an underlying flare - and after a month, just disappeared by itself for no reason.
It is possible that you won't respond to Humira. I can't remember the figures exactly, but I seem to recall that something like about 33% of people don't. As mataribot says though, it's really to early to be sure of that yet. If and when that happens, we are all blessed to have lots of other options to try, and in the meantime, those suggestions by michael sound rather soothing :)
Sorry about that - I didn’t mean to confuse the issue - it’s not part of PsA, it’s another autoimmune inflammatory disease humira works for (inflammatory bowel disease). Dear me - sometimes i do overcomplicate things!
Jen said:
that's k. I appreciate the info. I want thinking those lines when i read it our i would have known what it was. Thanks :-)Sorry about that - I didn't mean to confuse the issue - it's not part of PsA, it's another autoimmune inflammatory disease humira works for (inflammatory bowel disease). Dear me - sometimes i do overcomplicate things!