My mom was diagnosed with Psoriatic Arthritis a bit over a year ago. It’s prettg disabling with inflammation in her right foot, ankle, left knee and sometimes her elbow/fingers. She has a hard time walking. After not feeling any relief from the “lesser” drugs, they put her on Otezla. After a few months of that with no relief, they tried Humira. After 3 months of that, they’re putting her on Enbrel. Just looking for some hope from people who have unfortunately gone down this road. Will anything help?
It sounds like her doctor is moving through meds fairly fast. It’s great that she qualified for biologics so fast but I’m surprised that they have done such short trials. Disease modifying meds such as methotrexate or leflunomide may be left on board while being put on biologics.
I have to tell you. My doctor left me on MTX for 6 months with no relief before stopping it. I was on leflunomide alone for a year or two before being put on a biologic. Is there a reason why so fast?
Thanks for the response! He’s a relatively young doctor who wants to get her inflammation under control before it causes permanent joint damage. She is still on methotrexate and has been while she went on Otezla and Humira. I feel the same as you, perhaps the doctor isn’t allowing enough time for the drugs to kick in. His major concern was that more joints are being effected even though she’s been on Humira with the methotrexate for about 4 months.
Hmm. I wonder if a second opinion might be in order. If you’re willing to go into the city, she might be able to have a team approach at a few of the hospital centers, including I think New York Presbyterian and the Hospital for Special Surgery.
Unfortunately, I don’t think she will be willing. I was wondering if anyone has had experience switching from Humira to Enbrel. If Humira didn’t work, would Enbrel?
There are lots of people with all sorts of experiences. You can also do a site search using both search terms and see what you come up with.
I haven’t had the experience, as both Humira and Enbrel work for my arthritis. The studies I have read, though, indicate that there is the same chance of success with a second anti-TNF biologic (i.e. About 60-70%), whether the first one worked or not, and same with the third etc.
After that, there are a number of other styles of biologics (or that work on the IL6 or IL23 component), I’m not really up with them all anymore!
Whilst the traditional DMARDS can take a long time to seem to have an effect, most people will notice at least a starting glimmer of improvement on the frequently-dosed biologics (like Humira or Enbrel) within one to two months. It often continues getting better over time for quite a long time (1-2 year), but if there’s been no improvement at all in 3 months, a change of biologics certainly seems to be considered a reasonable option by some Rheumys and patients.
It’s great to hear your Mums Rheumy is at least taking things seriously
The interesting thing about DMARDS is that the more recent research has found them to be VERY helpful/effective when a biologic is doing its job(even poorly)
Good luck to your mom, thereshegoes22, I hope Enbrel works for her! I don’t have experience with any of the others or MTX–Enbrel was my first weapon against PsA and it has worked great!
Hmm, I have move from medications usually after 3 month to 6 month periods before ruling it out. If I am removed more quickly it is from adverse reactions. I am looking at you otezla. That one did weird things to me. Had to stop.
it made me as windy as Kansas in the middle of tornado season
I was on MTX pills for about 4 months and then MTX shots for 6 months with no relief before my dr put me on Enbrel. I’ve been on it for 3 months now and haven’t really experienced life changing improvement unfortunately (I was so hopeful). Had a follow up yesterday and my dr wants me to continue with the Enbrel until January and then if no more improvement, he wants to try Humira next. Still taking Duexis twice as day as well and he just bumped me to 3 times a day (for shorts periods) when the pain in unbearable. Based on what my dr said and most folks on here will tell you, this is par for the course unless you are lucky and hit the right meds on first or second try. It’s exhausting, physically and mentally for sure!
I really appreciate everyone’s input. I’ll update you with how my mom’s doing. She’s been very down lately. Some of these replies give us hope.