Should I stay on TNF-a Blockers?

I was diagnosed with PSA and psoriasis four years ago. My psoriasis is not that bad but my PsA is very severe. I have been on Humira, until it started to cause burning in my hands and feet, I briefly tried Enbrel but started to get headaches.

One of my most recent drugs was Cimzia. It worked great for the first 5 months but then started to completely wear off. I was taking my Cimzia injection once every two weeks. About 5 months into it, I noticed my pain would come back a day before the next injection. Then, during the next injection period, the pain would come back after 8 days. Then, during the next injection period, the pain would come back after 6 days. Then, 1 day. My rheumatologist switched me to Simponi. I took Simponi and the very next day, I felt like 80% better, but the following day, my pain started to come back. I have been on Simponi for a little over three weeks and I am still getting worse. I don’t think it is working. I told my rheumatologist about what Simponi is doing and he said that we can try Remicade or something that is not a TNF-a blocker. He said that it is possible that my body is not absorbing the injection and that an infusion based drug like Remicade might help.

I am getting in pretty bad shape and not sure how much longer I can continue to work. Should I try Remicade or do you think my time with TNF-a blockers has come to an end?

Why not try one more in the class? Although I do recall my rheumatologist saying something about the first one typically works best, and you typically get less of a response. Alright, maybe I’m changing my response. The good news is that there are multiple other classes of medications now, and you should be able to get a better response. You know that? If you’re in bad shape, request to move on to a different class.

I was on Remicade and loved it. It made me feel like the days before PsA. However, my insurance company switched me to biosimilar…Inflex something. I had a horrible, life threatening allergic reaction - elevated heart rate of over 200 for more than 6 hours, severe shivers…it was bad. Waiting to see if I can be switched back but I had very good luck on Remicade.