Rheumatoid Arthritis Support Group

Humira is only the second Biologic you've tried correct? You've still got Orencia (abatacept), Remicade (infliximab), and Kineret (anakinra) to try before you are out of first stage biologics. I wouldn't loose hope yet.

There are also several new drugs coming down the pipeline in the next couple of years....

New Biologic for RA Nears Approval
Posted 7/29/08
The Arthritis Advisory Committee of the U.S. Food and Drug Administration (FDA) recommended approval of tocilizumab (Acetemra), an interleukin-6 (IL-6) receptor-inhibiting biologic therapy, for the treatment of moderate to severe rheumatoid arthritis (RA) in adults...

R788 for RA Goes to Phase IIb Clinical Trial
Posted 6/18/08
Two Phase IIb clinical trials of the orally available Syk inhibitor, R788, are being initiated in people with rheumatoid arthritis (RA). The trials will evaluate the efficacy of R788 (fostamatinib disodium) compared with placebo. The trials are studying patients who have failed to respond to methotrexate or at least one biologic agent. Results are expected to be available late 2009.

http://www.arthritis.org/pipeline1...

Acemtra is already available in the USA...not in Canada yet.

http://www.arthritis.org/tocilizum...
Posted 6/17/08

Tocilizumab plus methotrexate showed significant clinical improvements in efficacy and safety in patients with moderate to severe rheumatoid arthritis (RA) who had not adequately responded to anti-tumor necrosis factor (anti-TNF) therapy, according to a new study presented at the Annual Congress of the European League Against Rheumatism. Tocilizumab, an anti-interleukin (IL)-6 receptor monoclonal antibody, was demonstrated to be effective irrespective of the number of, or the most recently failed anti-TNF treatments....

CIMZIA (certolizumab pegol)
http://www.cimzia.com/rheumatoidar...

Is another new drug that was recently posted in the forum. I havn't heard too much about this one yet... its just like the other TNF drugs.

I've been on Enbrel and Humira, then Orencia, and getting ready to start Simponi

I was on Enbrel, Humira, I am on Orencia..Since Humira and enbrel failed, Remicade will not work for me according to my doc, so he will put me on Rituxin. Simponi was discussed but doc decided that it may not work , just like enbrel and humira.

Enbrel, Humira and simponi are all injectable tnf blockers. I'm pretty sure Remicade is the infusion form of TNF blocker so I see your doctor's logic. Rituxin is targeted B cell therapy. Orencia blocks T cell activation - I'm waiting out this one too. Kineret is injected daily. It's an interleukin-1 - receptor antagonist.

I know how you feel about getting toward the end of the line of drugs. Lynn has pointed out some new things that are coming down the line.

I don't know if my rheumy is correct or not, but when Enbrel wasn't working and I was waiting for insurance approval of the next drug, he said to keep taking my injections. According to him even if it didn't help the pain and inflammation it was still protecting my joints from damage. Has anyone else heard this?

I feel for you snixy. my liver function tests are really elevated and they keep halving my methotrexate dose and retesting. It's been the only thing that has helped even a little. I'm afraid soon my hands will be lobster claws again. Maybe we could get a group rate to the UK. Medical tourism is big business these days. Mexico scares me a little. I had a bad experience there once.

I've been doing a ton of reading trying to get into my brain what all these things are and what they do and what the terms mean. I know a little knowledge can be a dangerous thing. I have lots more reading to do.

I take Kineret which clears through the kidneys, and just switched from methotrexate to sulfasalazine. I haven't felt this good in years. I don't have any flares unless I don't take my meds, like before I had surgery in April, and when I went off mthx because my ALT for liver was in the danger zone. I am hoping this combo will work a while.

Kineret is excellent. I had 75 swollen joints and was in a wheelchair before I went on it. You are not at the end of the journey through med land by far. I have found that all my meds worked really quickly.

Some doctors don't become too concerned until SED rate is over 100. Don't get too stressed about it.Mostly it helps keep track of TX effectiveness.
There are so many tratments available - be patient. Give them time to kick in. Sounds like you have good doctor.
Hugs,
Vee

My CCP was 250, my Rf 109 my CRP 3.9(high)
my SED 27.

My Rheymy said, he is not concerned about the numbers as he is about my overall swelling, stiffness tenderness, flares another words, he feels the drugs will take care of it in the long run. Right now it's my Liver he is more concerned about(Alt 185), but once I get off Pred which caused it the last time, it will get back to normal.
So I would ask your Dr. if he ic concerened about it and if he says no then trust he knows what he is doing. You can help with the numbers to go on a totally anti inflammatory diet and I'll bet your numbers will change. Checkl out. www.drweil.com Good luck

See bc2 about Rituxan. Wow, that is insanely high, I'm so sorry! As always I get this false sense of guilt about answering your question. The week before my wrist froze up on me, mine was actually 0. My RD said that was lower than Hers! But, it's a bouncy ball. I'll see what it is this time.