MTX and Enbrel

[Guest guest]

I went from MTX to Humira and MTX to only Humira. I am a bit worse then with

the combo but would rather not take MTX.

I just switched from Humira to Simponi. Not sure about this choice. After one

shot and 3 weeks I'm suffering pretty bad again. My rheumy says to stuck on it

for at least 3 or 4 months....kind of wish I had stuck with Humira at this point

but I travel a lot and simponi is more practical. Maybe I'll go back on mtx

with Simponi....

[Guest guest]

: I'm new to MTX but my doctor tells me that it typically takes longer

to work than the biologics, i.e. maybe as long as 4 months to get relief. I've

not had to take prednisone but for most, I think it offers quick relief so I

can't offer any help there except to say that it's surprising that it didn't

work.

With regard to whether to start on Enbrel or Humira or - for that matter -

Remicade, it's up to your doctor. They are all three TNF blockers and do

basically the same thing; so I don't think it makes a lot of difference which

you start with. I was on Enbrel for a while and got great relief from it but

felt that my PsA was not bad enough to justify the cost - which, for me (since

I'm on Medicare RX) ended up being about $4,000/year. So, I asked to try MTX.

My internist actually believes that MTX - at least for me - is the safest

option. The only serious side effect is the potential for liver damage but

that's why blood tests are mandatory every two months. If there is going to be

a liver problem, they want it caught early because then can then stop the MTX

and the liver will typically heal itself.

The reason your rheumy may want your partner to stay on MTX while going on one

of the biologics is likely because so far nothing has worked to provide relief.

Studies have shown that - in such cases - MTX in conjunction with a biologic

gives much better relief than either alone. There apparently is a kind of

" multiplier " effect (for lack of a better term) that you get with taking both

together. It is not uncommon in " tough " cases.

One additional thing to be aware of: in some cases, people with PsA will take a

particular biologic and it works well for some years and then - for some unknown

reason - it stops working and they have to switch to another, which often then

will take up where the first one stopped. So, it's good to have more than one

out there on the market; and new drugs are being developed to treat the

inflammatory arthritis's all the time. So, hang in there . . . .. . relief will

come.

Joanna Hoelscher

________________________________

From: rebeccafre <rebeccafre@...>

Sent: Sat, November 7, 2009 9:21:21 PM

Subject: [ ] MTX and Enbrel

Hi All,

My partner was diagnosed with PsA about 6 months ago and has been on MTX for the

past 2 months with no relief. Then the rheumy put her on prednisone, but again,

no relief. Now, the doctor wants to put her on Enbrel or Humira, but keep her

on the MTX. Our question is this...if the MTX isn't working, why does she need

to stay on it with the Enbrel or Humira? Does anyone take Enbrel or Humira by

itself with success? And which drug should we start with? (And since MTX is so

toxic in the first place, why stay on it if it's not going to work?) Any

feedback would be HIGHLY appreciated!

[Guest guest]

,

I've had my 2nd shot of Simponi and 3rd will be this week. I am steadily

continuing to improve and my skin has really cleared a lot. It took a

couple weeks after the 2nd shot to really see improvement. After the 1st

shot, I did see less fatigue which was a huge blessing. I hope your 2nd

shot will show some improvement for you.

[Guest guest]

PsA is a spondyloarthropathy. There have been studies showing MTX does not work

for us. It does work for rheumatoid and we always get their hand-me-downs so

that's why the 2 are still so widely prescribed together. I have functioned well

on just Enbrel for seven years. I was taking MTX and just found it ever so easy

to quit once the Enbrel kicked in.