Rheumatoid Arthritis Support Group
Rheumatoid arthritis is a chronic, inflammatory, multisystem, autoimmune disorder. It is a disabling and painful condition which can lead to substantial loss of mobility due to pain and joint destruction. The disease is also systemic in that it often also affects many extra-articular tissues throughout the body including the skin, blood vessels, heart, lungs, and...
I just got a message from my rheumy with my most recent blood test results. With these results, he wants to discuss a med change. He said I could call the office to get an earlier appt than my scheduled appt for 3/31.
I'm currently on Enbrel/MTX and have felt the best since being diagnosed. (I previously tried Plaquenil and Humira/MTX). I still have some pain in my wrists but it pales in comparison to all the pain/swelling pre-Enbrel.
I am terrified to start a new medication when I still feel like Enbrel is 'working' for the most part. I feel pretty good and have even been able to return to regular exercise classes. Is it worth the risk to switch? Why upset the apple cart?
From a numbers perspective:
I was on Humira from April 2012 thru January 2014. During that time, my average CRP was 4.35 with a high of 10.16 and a low of 2.19. My SED rate avg was 68 with a high of 107 and a low of 45.
I started Enbrel in January 2014. Since then, my average CRP is 2.95 with a high of 5.03 and a lo of 1.27. My SED avg is 47 with a high of 63 and a low of 31. I did have a major flare in October that skews these numbers a little on the high side.
So, my question is what were your numbers/pain levels when you made a biologic switch?
I'm currently on Enbrel/MTX and have felt the best since being diagnosed. (I previously tried Plaquenil and Humira/MTX). I still have some pain in my wrists but it pales in comparison to all the pain/swelling pre-Enbrel.
I am terrified to start a new medication when I still feel like Enbrel is 'working' for the most part. I feel pretty good and have even been able to return to regular exercise classes. Is it worth the risk to switch? Why upset the apple cart?
From a numbers perspective:
I was on Humira from April 2012 thru January 2014. During that time, my average CRP was 4.35 with a high of 10.16 and a low of 2.19. My SED rate avg was 68 with a high of 107 and a low of 45.
I started Enbrel in January 2014. Since then, my average CRP is 2.95 with a high of 5.03 and a lo of 1.27. My SED avg is 47 with a high of 63 and a low of 31. I did have a major flare in October that skews these numbers a little on the high side.
So, my question is what were your numbers/pain levels when you made a biologic switch?
My sed rate went into normal range and crp went below .3 (that's 3/10 of one).
Is your doctor working from October blood numbers? It's not really decided by an "average"...but from current. What were the numbers most recently taken?
With that said, if you feel pretty good on your current medications then don't change - simple as that.
Now that I've been on Humira for a good solid 6 months I feel better than I have since this all started 3-4 years ago. For me it's a simple conclusion to just stay the course. It's not perfect of course but I've come to the conclusion that this is as good as it is going to be for me.
I assumed that if SED falls into normal range, that is a big indicator of remission. And while I would love to reach remission, I guess I view it as a low possibility (based on what I've read).
I'm on 17.5 mg of MTX and have little side effects (hair loss) so maybe increasing MTX is an option.
bcatz - are you considered in remission?
I also had an 14.3.3 eta test which he said shows a very small risk of damage at this time. It's a fairly new test and my first time taking it.
My remission though wasn't just the blood work. It was blood work, how I felt (only two joints had any issues at all then), and xrays.
It's great you are feeling better. You still have a long way to go but since you are improving, maybe just adding another dmard is all you need.
Before the biologics were added, my sed rate was elevated in the 60s but my CrP was always completely normal. And i was crippled.
CRP 15.7
SED Rate 65
Platelet Count 548
That was mid-October, 2014. The next day, after my first Enbrel shot, I felt 100% better and I have been feeling very good since then. I don't know what my numbers are today, but based on how I feel, I bet they are a lot more like they were a few years back, when things were under control. Back then, my numbers were as follows:
CRP 0.6
SED Rate 12
Platelet Count 316
I say if you are feeling good right now, ride that wave as long and as far as it will take you. Knowing this disease like I do (45 years of it), it will give you plenty of opportunities to (need to) try new meds.