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...
Hey all! Long time no chat!!
I see some newer screen names in some of the conversations than I remember...so long story short - I have Psoriatic Arthritis (not RA), but I love this board for several reasons. AND I can't find a decent PsA board, so I pop in and out of here often. :)
Anyway, I'm wondering if anyone has input on Remicade vs Humira. I've been on Sulfasalazine since mid-December now, and today just asked for the last increase I'll be allowed before I'm maxed on the dosage amount and then I'll be moved to something else...it just wasn't mentioned to what biologic. I take Sulfa, Celebrex, and Tramadol currently.
So I've been researching, and based on my insurance I am looking at proposing Remicade or Humira (I'm eliminating Enbrel off the bat because my out of pocket cost would be double the other two, and just no). I'll have to get a special form filled out from my doctor for Humira but not Remicade, though both will require a review from my doctor to my insurance of course. And I've already cycled through prednisone and NSAIDs and a DMARD. My doc doesn't want to even try MTX with me because I am still contemplating trying to start a family at some point in the future, I'm only 31, and she is a hardcore preserver of any chance of fertility and took that off the table without discussion. And I was ok with that decision.
My problem is this: the sulfa has helped me be able to at least tolerate laying down at night for bed (when I was just taking the pain meds it was a nightly fight to get comfortable and calm the stabbing and crushing pain i get in my SI joints), and helped my morning stiffness to a degree, but my daily discomfort still sucks most days. I have a lot of axial involvement and it makes sitting for long periods impossible...and I of course have a desk job. I realize RA and PsA present a little differently. But y'all are the only folks I can go to for input on any of this really.
Sorry for the long drawn out post!! And I am sending well wishes to you all.
I see some newer screen names in some of the conversations than I remember...so long story short - I have Psoriatic Arthritis (not RA), but I love this board for several reasons. AND I can't find a decent PsA board, so I pop in and out of here often. :)
Anyway, I'm wondering if anyone has input on Remicade vs Humira. I've been on Sulfasalazine since mid-December now, and today just asked for the last increase I'll be allowed before I'm maxed on the dosage amount and then I'll be moved to something else...it just wasn't mentioned to what biologic. I take Sulfa, Celebrex, and Tramadol currently.
So I've been researching, and based on my insurance I am looking at proposing Remicade or Humira (I'm eliminating Enbrel off the bat because my out of pocket cost would be double the other two, and just no). I'll have to get a special form filled out from my doctor for Humira but not Remicade, though both will require a review from my doctor to my insurance of course. And I've already cycled through prednisone and NSAIDs and a DMARD. My doc doesn't want to even try MTX with me because I am still contemplating trying to start a family at some point in the future, I'm only 31, and she is a hardcore preserver of any chance of fertility and took that off the table without discussion. And I was ok with that decision.
My problem is this: the sulfa has helped me be able to at least tolerate laying down at night for bed (when I was just taking the pain meds it was a nightly fight to get comfortable and calm the stabbing and crushing pain i get in my SI joints), and helped my morning stiffness to a degree, but my daily discomfort still sucks most days. I have a lot of axial involvement and it makes sitting for long periods impossible...and I of course have a desk job. I realize RA and PsA present a little differently. But y'all are the only folks I can go to for input on any of this really.
Sorry for the long drawn out post!! And I am sending well wishes to you all.
I won't go into how they are made but more of why they are used. It is theorized that a part of our immune system gets turned on and then won't turn off and the excessive amount of that immune factor then turns on the body itself. So the biologic drugs we use "inhibit" that turned on factor...like neutralizing it in the blood.
The factor most commonly targeted is the Tumor Necrosis Factor and 5 of the biologic drugs work to inhibit that factor. They are Remicade, Humira, Enbrel,Cimzia and Simponi. There are other biologic drugs that inhibit other factors as well....Actemra inhibits Interleukin 6, Kineret inhibits Interleukin 1. Then 2 biologcs deplete certain factors.....Rituxan depletes B-cells and Orencia depletes T-cells. Another biologic, Xeljanz, inhibits a different factor at the sight of the inflammation and not in the blood stream...the only pill.
So as you can see, both Humira and Remicade do the same thing so it becomes whether either will help and if you want to do shots at home or infusions at the doc's office or infusion center.(Question for all...is Remicade now available in shot form?????)
Humira is given every 2 weeks initially and Remicade infusions are every 8 weeks. Both can be given in shorter intervals if necessary.
Many insurance companies now have deals with the pharmaceutical companies and will only pay for certain biologics so of the 2, it's really about timing and convenience and does it help. Most of us have been on several biolgoics trying to figure out what will work.
Welcome to being a "patient patient".
Jen
I would go with whatever your doctor recommends. And whichever one won't harm your ability to have children! I guess I was lucky in that all my 4 children were born and mostly grown up when I got RA.
Marlene - yea true, unfortunately any medication cana fect the liver (especially pain meds) since the liver does most of the processing and filtering in the body :(
racerunner - woooowwww yea I definitely understand... from what I looked up with my insurance, remicade and humira would cost me the same out of pocket per "30 day supply". I might need to call them and get clarification though, because if remicade is done frequently at first then spaced to every 8 weeks and the premeds etc, it might make the cost different in the beginning for sure. Good point, thank you.