Or at least it could be according to this: http://www.jrheum.org/content/early/2014/11/11/jrheum.140685
Hate to ruin anybodies Christmas.
I’ll be perfectly honest with you. I have tried this drug twice and couldn’t stomach it.
However, it would be interesting to see how Stelara and next crop similar Biologics performance with MTX. In general they are reporting less drug antibodies.
I have to say that while MTX makes me feel like I have a nasty hangover 1 to 3 days a week and requires me to take an insane amount of folic acid tablets, it also has proven to be very much a good thing for me all the time that I've been taking it. I'm all for this medication, and I'm glad that I started out with injecting it.
Tnt, do you know if any of the newer biologics are going to do better as monotherapy?
Stelera and few new ones coming on BUT they are not TNF-alpha. inhibitors they go after different things. We frankly don't know yet about the antibody situation or for that matter how well they even work. I suspect Stelra is going to be looked at pretty hard as it is not a pure IL-23 or IL-12 inhibitor. Its effect on IL-12 is having some pretty bizzare effects or the combination of inhibiting IL-12 AND IL-23.
The main one is Guselkumab. Phase 2 studies have it with a dang near 88% success rate and kicking Humiras butt big time at all levels: amount of relief, number it relieves, side effects, and on and on. They are using the R word in regards to Psoriasis and I have even heard the C word thrown around.........
Martibot, I just have to laugh when you say "stomach it" in regards to MTX..... It may not be funny, but you gotta laugh!
rosen said:
I have to say that while MTX makes me feel like I have a nasty hangover 1 to 3 days a week and requires me to take an insane amount of folic acid tablets, it also has proven to be very much a good thing for me all the time that I've been taking it. I'm all for this medication, and I'm glad that I started out with injecting it.
Tnt, do you know if any of the newer biologics are going to do better as monotherapy?
I figured it out! Really--R AND maybe even C?????? You mentioned all those good things about Guselkumab--how about price? Is the price also kicking Humira's butt?
Depends on whether you are buying or selling................. :-) :-) it comes from the Remicade people.
Grandma J said:
I figured it out! Really--R AND maybe even C?????? You mentioned all those good things about Guselkumab--how about price? Is the price also kicking Humira's butt?
Thanks! Well, wouldn't C be great?? Cost may be irrelevant if it can cure us! I'd even settle for R!
How far along in the disease process are the people that are going into remission? I've read about that medication, and it does sound promising.
Umm, it’s not really funny at all! I spent Saturday’s hunched over a toilet. Add plaquenil and I had both ends on toilet!
tntlamb said:
Stelera and few new ones coming on BUT they are not TNF-alpha. inhibitors they go after different things. We frankly don't know yet about the antibody situation or for that matter how well they even work. I suspect Stelra is going to be looked at pretty hard as it is not a pure IL-23 or IL-12 inhibitor. Its effect on IL-12 is having some pretty bizzare effects or the combination of inhibiting IL-12 AND IL-23.
The main one is Guselkumab. Phase 2 studies have it with a dang near 88% success rate and kicking Humiras butt big time at all levels: amount of relief, number it relieves, side effects, and on and on. They are using the R word in regards to Psoriasis and I have even heard the C word thrown around.........
Martibot, I just have to laugh when you say "stomach it" in regards to MTX..... It may not be funny, but you gotta laugh!
rosen said:I have to say that while MTX makes me feel like I have a nasty hangover 1 to 3 days a week and requires me to take an insane amount of folic acid tablets, it also has proven to be very much a good thing for me all the time that I've been taking it. I'm all for this medication, and I'm glad that I started out with injecting it.
Tnt, do you know if any of the newer biologics are going to do better as monotherapy?
Both ends are the worst..... been there. You just hope there is time to flush between events......... But it was a funny play on words.
I read that "Hate to ruin antibodies Christmas." :)
I can't take mtx, as I'd like to keep my liver thankyouverymuch, but it was an interesting read.
Lamb, if I've understood this correctly these results also show that Enbrel produced the least anti-drug antibodies - zero in fact - in the study patients. This has got to be good news for everyone on Enbrel whether they also take mtx or not.
I wish they had included golimumab (Simponi) in the study so I could get an understanding of the development of ADAb's on this. Wonder how easy it would be to get my blood tested for ADAb's here in the UK? Got my next consultants appointment on January 6th so definitely going to ask about it. Definitely wishing I'd been put on Enbrel not Simponi after the Humira failure!
Thinking the chances of changing bio again are about nil so think I might have to be willing to give mtx a try again. I seem to recall that 10mg is the minimum dose and last time even this was intolerable for me (oral and injected). Is there any evidence that an even lower dose has some/any efficacy?
And fascinatingly, the rate of antibodies is markedly different in RA and IBD… At least with Humira - it’s an esoteric study , I’ll see if I can dig it up (meanwhile, I’m on the IBD end, so enjoying a wine, and not MTX, this week).
Jules,
Here is a link to the Abbvie concerto trial. It looks like 10 mg is the cut off point.
This thread was a "teaching set up" and lesson in researching. Sorry (not really) Check out this thread and be glad you atre not one of my students...........
Hey, I'm an unschooler. I can handle it!
One article concludes: Conclusion Significant levels of ADAb were present in up to 29% of patients with PsA treated with ADA or IFX. ADAb clearly correlated with low therapeutic drug levels and higher disease activity variables. The use of MTX significantly decreased ADAb prevalence . . .
The other ends with this gem of wisdom: Conclusions: There is no clear association between adalimumab serum levels or antiadalimumab ADAbs with clinical response to treatment or with relapse upon treatment discontinuation in pSpA.
Is this somewhat like the difference between "It's the thought that counts" and "The road to Hell is paved with good intentions"? What does the third study say? How does any of this relate to non-TNF blocking biologics? Is it all just a giant crapshoot?
Thanks Ali, this is really interesting.
10mg looks like the ideal minimum dose but with 2.5mg and 5mg showing >40% low disease activity I think, with my track record, I'd be prepared take these odds and try a low dose to see what happens.
Of course I'm not bio-naive nor likely to be going back on Humira but even so it seems there might be nothing to lose.
And hey, what's another few weeks of waiting for something to happen or not? And if I end up with all the side-effects back again then at least I know it really isn't for me and can stop taking it.
On my list of discussion points for January 6th!
Ali said:
Jules,
Here is a link to the Abbvie concerto trial. It looks like 10 mg is the cut off point.
http://www.drugs.com/clinical_trials/abbvie-study-assesses-role-pre...