the insurance company may have the last word. you probably will have to start with enbrel or humira, and possibly try both, before you go for any of the others. i'd check with your insurance company to see what their requirements are. some want you to take a medication for six months before they consider it 'failed' and will cover the next one.

most people start with enbrel or humira. they have been on the market a long time and have the most research. i chose enbrel for that reason. i think my next step would be humira.

i haven't experienced any real relief yet. i have noticed my fatigue is lower, but i think that may be stress-related because i've been focusing on stress relief a lot recently. (not that it's helped tremendously, but it has helped lol.) i've also researched the theory that injury activates rd, and that certain foods trigger it. i haven't come across anything that makes sense to me, so i'm not really focusing on that. i'm more concerned with what will give me my life back ;)

You have to keep in mind that we all react differently to various meds
and biologics and also may experience different side effects. Enbrel seems to be used commonly as a first choice Biologic.
Enbrel and Humira both are TNF blockers whereas Orencia is a T-cell blocker.
Orencia is one of the slowest acting biologics and can take up to 6 months to start working.
I found Enbrel worked for a while but I had to stop because it caused drug-induced Lupus (a very rare reaction). Orencia had no side effects but it didn't do a great deal for me.
Hope this helps a bit and I'm sure you'll have plenty answers.
Good luck

Steph is right-the insurance company may have the last word. I wanted to start Orencia and my rheum was ok with it, but Blue Cross wouldn't approve. Instead I started humira. So far it's working really well. Still some stiffness in fingers and my bad wrist, but overall much better. Good luck.

Well, I'm leaning towards enbrel now to clarify.

*Enbrel is a soluble form of p75 tnf receptor that can bind to tnf molecules. It inhibits binding of tnf a and tnf b to cell surface tnfr rendering it inactive.

*humira binds to tnf a blocking interaction with p55 and p75 cell surface tnf receptors.


So enbrel inhibits binding together, humira binds and blocks.

I suspect neutrophils gone haywire with my injury, and it plays a role with tnf a.

I just would like some input on what your all's personal experience with these meds were to help me be more informed. Thx all!!

while they have all been around for a good while, Enbrel was the first. I chose to go with it because 1. you take weekly injections so if something goes wrong, you don't have a month's worth of infusion left in you at any time. 2. oldest - still approved = positive for it 3. Because it's been around so long, if you have a side effect, there is a better chance of it already being documented and researched.

What others posted is totally true. Insurance might not allow at home injections or might not have all the biologics approved. You might have to fail on a regular dmard longer than you have, too. Additionally, so RA doesn't respond to one or more biologics. That makes a huge difference.

It's wonderful that you are taking responsibility for your situation and getting involved in your treatment! Gotta be you own best advocate!

Thank you, I am very involved in all my medical care. The good thing is this rheumatologist is open to my opinion. Last visit arava was causing severe gi upset and I was still flaring in spite of it. She asked what I wanted to do next. I suggested plaquenil so she wrote me a script, and then altered my arava dosing. I am so grateful for her. She is, in my opinion, an excellent rheumatologist.

Seems to be insurance dictates.
With Enbrel being the first or Humira.
I did well on Enbrel for almost 2 yrs & the good thing about it was no waiting for months to kick in.
Whatever you choose I wish you the best of luck.
Sammy

My first doctor asked for Enbrel, but the insurance company insisted on Humira first. Unfortunately, they call the shots, with the price of these meds.

The doctors office may have an in office program that helps u as well. I went by what my doctor recommended. Best of luck to you.

my doctor suggested remicade and i am on it. i have my second iv next monday.

that is very good that you are taking your choice and doing all this research. great. and thanks for posting. i came to know a lot about biologics. you guys are great. i am glad that i am a part of this amazing group.

My doctor also asked me which one I wanted to start on.... I picked Humira mainly because it was 1 shot every 2 weeks instead of weekly like Enbrel (yeap I am a chicken!)
But thinking now to when I was sick in December... I would have missed 3 Enbrel doses, where as I only missed 1 Humira dose.... so wondering if missing all that extra meds would have made things worse?

I had really good luck with the Humira up until missing that dose, now it seems as if my joints have been flaring, but then the weather has been TERRIBLE this winter.... I am holding out with the Humira, waiting for the weather to calm down and my next Rhuemy visit before deciding that maybe it quit working. Next visit is in May, so either things get better or it maybe time to move on.

Good luck
Cindy

I had very good success with Humira for about three years. It seems to have stopped working for me now - since last August - I would say I have been having a "flare-up." I believe I caused it because I was feeling so good, I thought I could do things that normal people do (like join a gym and do regular people exercises). That caused this horrible flare with my wrists and I've been in fight mode ever since. I go back to my doc this Wednesday to see what else he has in his magic bag for me. I am willing to try Enbrel and I think my insurance would also allow that.

I have constant wrist pain and I'm on Humira. I don't advise it. I'm switching to Cimzia in 2 week. I felt it worked well for about 4 months, then prednisone had to be added and I feel I'm only functioning now because of the steroid. So I wouldn't pick Humira but everyone is different! Good luck!

Cindy you can take Humira weekly for 3 months fyi.

When I decided to use a biologic I went with Humira. this was because I am a needlephob and the injections were less often than Enbrel. It had also been around nearly as long. I didn't get the outcome I wanted which was to be painfree and to feel pre-RA so I stopped.