Re: HELP!!! NEED TO MAKE A DECISION

[Guest guest]

In a message dated 12/17/03 2:15:40 PM Central Standard Time, Rheumatoid Arthritis writes:

Message: 4

Date: Wed, 17 Dec 2003 19:06:18 -0000

From: barbaraquinlan@...

Subject: HELP!!! NEED TO MAKE A DECISION

I met with my rheumy yesterday and we have determined that the

methotrexate is not working. Therefore he has given me the option of

Enbrel, Humira or Remicade. From what i can see, none of them are

much fun. But what i need to decide is which is best for me. Any

suggestions or comments from those that have taken these treatments.

I am to call him soon with my decision.Im just not sure i can give

myself injection.

Hi,

I have been on Embrel for the past 10 weeks. so far so good. I have been taking methotrexate by injection for months now due to side effects from the pills. You take Embrel twice a week. Its easy and the support staff from Embrel itself is great!! I would try Embrel or humeria first...then if that doesn't work go on to Remicaide.

You doc should have given you info about all three biologics. The drug companies will provide you with tons of info as well as they can help get it approved through your insurance.

I am a busy active person so self injection was the only way for me. I was not giving up my time to sit in docs office for 2-4 hours for Remicaide infusion. Not to mention I have terrible veins so even getting and IV usually means having to call down someone from the neoate unit that sticks the tiny premature babies!

You docs nurse should to plenty of patient teaching and will require you to take the first few shots with you in the docs office so they can monitor you. The needles are small insulin needles so its really no big deal.

Embrel also has a wonderful newsletter. They send you their resource kit,in it a mat so you can gather your supplies and have everything handy. A book that details the mixing, storing and injection process, a video that details the same things. A travel sharps container to put you used needles in and a home sharp container which is far larger than the travel. The sharps containers they will mail to you upon request as you fill them up. There is also a tool sent for those with limited mobility to help get the caps and plugs off the meds. Then there is a travel cooler with ice pack for those times you need to leave from home. All of the biologics have to be refrigerated. I have been really impressed with the support. They also sent me a calender and a sheet of stickers to place on my calander to remind me to take my injections.

I believe Humeria is also a twice a week injection. But it comes in prefilled syringes that you remove the tops and injection. I think they also have a support type resource center. I have heard peeple complain about dull and large injection needles with Humeria. I am sure others can give you more detailed info on this.

You will still stay on your methotrexate as I am still on mine. MTX is designed to use in conjuction with the biologic DMARDS. I would also recommend going to MTX injections over pills if you are getting lots od side effects as I did. I had terrible diarrhea, nausea, dizziness and headache. Not to mention terrible stomach pain.

Good luck,

Toni

[Guest guest]

I just joined this group & saw your post. I have had RA for a

little over a year so I am certainly not well versed. However, in

Nov. I saw a newspaper article about a new drug - infusion - from

Bristol Myers Squibb - has been tested on 339 patients - article

says has " few, if any, side effects. Only name I see is CTLA41g -

Bristol Myers Squibb will be applying to FDA in 2004 to sell the

drug. It is used with methotrexate.

Hope this is some help to you and doesn't just add to the confusion.

--- In Rheumatoid Arthritis , barbaraquinlan@s...

wrote:

> I met with my rheumy yesterday and we have determined that the

> methotrexate is not working. Therefore he has given me the option

of

> Enbrel, Humira or Remicade. From what i can see, none of them are

> much fun. But what i need to decide is which is best for me. Any

> suggestions or comments from those that have taken these

treatments.

> I am to call him soon with my decision.Im just not sure i can give

> myself injection.

[Guest guest]

I just recently started Humira (3 injections so far)on a weekly

basis. I felt that for me it would be more convenient to be able to

do this at home rather than sit in a hospital for half a day. I had

no experience in giving injections and was pleasently surprised at

how easy and rather painless it is. The needle is very small with

Humira and it is subcutaneous rather than intramuscular (that goes in

a little deeper)It is a personal decision as to what is most

convenient and comfortable for you and how you react to the

medicine. My doc is not sure I am responding too well to the Humira

(we are going to give it a month) and I might have to do the thing I

didn't want to, but whatever works. Ask your doc if he/she thinks

one would be more effective, offer quicker relief etc. and then weigh

that against your needs as to convenience, ease of use, getting over

fear of self injecting(it really isn't bad). I wish you luck and

good results in your decision. :-) Jen

--- In Rheumatoid Arthritis , barbaraquinlan@s...

wrote:

> I met with my rheumy yesterday and we have determined that the

> methotrexate is not working. Therefore he has given me the option

of

> Enbrel, Humira or Remicade. From what i can see, none of them are

> much fun. But what i need to decide is which is best for me. Any

> suggestions or comments from those that have taken these

treatments.

> I am to call him soon with my decision.Im just not sure i can give

> myself injection.

[Guest guest]

It could be that each drug, although all biologics, could affect you differently in terms of effectiveness. I started out on Enbrel and then switched to Humira. I guess that if the Humira stops working, then my doctor will switch me to Remicade. From what my rheumy told me, the TNF-inhibitor is the same in all three drugs - but the stuff that carries it (real technical here) is different (different solutions maybe) and it could be that your body is more receptive to one than the others.

This is the first time I've ever given myself shots. The first time I had to do it by myself, I must have sat there for at least 5 minutes with the needle poised above my leg thinking "This is just too weird for words." Very counter-intuitive, but much easier to do at home than go to the doctor's every 6 weeks for 4 hours, I think. Unless, of course, you want some time to yourself!

good luck,

gloria

[Guest guest]

I started Enbrel 5 weeks ago. I'm now weening off the Prednisone but

I do have better flexability.

The needles used for the injection are very small and you can learn

to do it in no time. I have had no reaction to the injections at all.

I've also been self injecting Methotrexate since August. Much better

than the oral doing, no yuckies from it.

Remicade is given Intra-Veiniously and is done in a doctors office or

clinic and takes at least an hour and up to three hours.

I'm not sure what the difference is between Humira and Enbrel. I

think they are both TNF2 inhibitors.

Best of luck and God Bless,

Jay

--- In Rheumatoid Arthritis , barbaraquinlan@s...

wrote:

> I met with my rheumy yesterday and we have determined that the

> methotrexate is not working. Therefore he has given me the option

of

> Enbrel, Humira or Remicade. From what i can see, none of them are

> much fun. But what i need to decide is which is best for me. Any

> suggestions or comments from those that have taken these

treatments.

> I am to call him soon with my decision.Im just not sure i can give

> myself injection.

[Guest guest]

BArbara, the injections are nothing...it is fear of the unknown!!! I am on

Enbrel, and it has been a Godsend!!!! You don't even feel the injection!!!!!

sherri

----- Original Message -----

From: <barbaraquinlan@...>

<Rheumatoid Arthritis >

Sent: Wednesday, December 17, 2003 2:06 PM

Subject: HELP!!! NEED TO MAKE A DECISION

> I met with my rheumy yesterday and we have determined that the

> methotrexate is not working. Therefore he has given me the option of

> Enbrel, Humira or Remicade. From what i can see, none of them are

> much fun. But what i need to decide is which is best for me. Any

> suggestions or comments from those that have taken these treatments.

> I am to call him soon with my decision.Im just not sure i can give

> myself injection.

>

>

>

>

>

>

[Guest guest]

Hi Barbara, This is Steph in VA. I have a different opinion. I tried Enbrel when it was first approved by the FDA. I got a pretty good response but felt it wasn't worth injected myself twice a week with disposing/traveling etc. This was also because I had just been diagnosed and didn't want to cause attention to myself. I tried Remicade because I felt it was easier to sit in a doctor's office or hospital (I actually got it through home health care for a year) for 3 hours than to tote it around (I do a lot of travelling).

I have now been on Remicade for 3.5 years. Remicade has worked great for me -- including allowing me to train for and finish the Honolulu marathon in 2001 and the Bermuda half-marathon in 2002. My doctors think the reason I have had such a great response is I started Remicade 6 months after I was diagnosed (8.5 months after the symptoms started).

You're right that Remicade, Enbrel & Humira are TNF inhibitors. Kineret is an interleukin-1 agent, but also a biologic.

Take care,

Steph in VA

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

> > I met with my rheumy yesterday and we have determined that the

> > methotrexate is not working. Therefore he has given me the option of

> > Enbrel, Humira or Remicade. From what i can see, none of them are

> > much fun. But what i need to decide is which is best for me. Any

> > suggestions or comments from those that have taken these treatments.

> > I am to call him soon with my decision.Im just not sure i can give

> > myself injection.

> >

>

Enjoy the holiday season with great tips from MSN.

[Guest guest]

My RD also gave me a choice of Remicade, Enbrel, or Humira.

What had me nervous about Remicade is it's composed of part mouse,

while Enbrel and Humira are all human components. I believe the

advantage of Remicade is it may be quicker acting and that the

doctors can more easily adjust the dose. I understand Medicare

covers it, but not Humira and Enbrel

I hear Enbrel used to have a dull needle, but that they've switched

it to a thinner one. It was also recently approved to be taken once

a week as well as twice a week. It was FDA-approved earlier than

Humira (12/02) so it has more data indicating it's safety.

I chose Humira. Humira comes in a thin needle, that's prefilled and

taken once every two weeks. I believe you have to mix things

together for Enbrel. I'm doing well on Humira. If I had to choose

again, I would probably go with Enbrel because of it's longer history.

Here's one site that compares the three biologics:

http://www.trends-in-medicine.com/Nov2002/ACRheum112p.pdf

Here's a site by the FDA that had detailed information about each

biologic.

http://www.fda.gov/cder/biologics/biologics_table.htm

Mike

--- In Rheumatoid Arthritis

--- In Rheumatoid Arthritis , barbaraquinlan@s...

wrote:

> I met with my rheumy yesterday and we have determined that the

> methotrexate is not working. Therefore he has given me the option

of

> Enbrel, Humira or Remicade. From what i can see, none of them are

> much fun. But what i need to decide is which is best for me. Any

> suggestions or comments from those that have taken these

treatments.

> I am to call him soon with my decision.Im just not sure i can give

> myself injection.

[Guest guest]

Hi Gloria,....I am new to Humira, just had my first injection last

week. I was scared also, but it's not that bad. The needle is

small, there is no mixing, no measuring. It's once every two weeks.

I must say, that I do feel better already. Meds work different on

everyone, and I would check out all the information on all of them.

Good luck, let us know thinking of you Tawny

[Guest guest]

I think cost may be the determining factor for a lot of people. I'm on medicare and they pay 80% of Remicade but nothing for the others. Some insurance companies pay for most or all of the injectables but less for Remicade. Some people have good luck with each of the drugs, but also some people have troubles with each of the drugs. It's a trial and error situation. Humira is made from all human protein, Enbrel uses about 1/3 protein from hamster ovaries, and Remicade uses about 1/3 protein from mice. From an aesthetic sense, Humira is likely to be the first choice - but cost and effectiveness also come into play. Also as approved by FDA Remicade is to be taken for RA along with Methotrexate so that people avoid developing a reaction against the medicine. It's not an easy choice. Good luck and God bless.

----- Original Message -----

From: barbaraquinlan@...

Rheumatoid Arthritis

Sent: Wednesday, December 17, 2003 11:06 AM

Subject: HELP!!! NEED TO MAKE A DECISION

I met with my rheumy yesterday and we have determined that the methotrexate is not working. Therefore he has given me the option of Enbrel, Humira or Remicade. From what i can see, none of them are much fun. But what i need to decide is which is best for me. Any suggestions or comments from those that have taken these treatments. I am to call him soon with my decision.Im just not sure i can give myself injection.