TNF inhibitor
Greetings all! I'm hoping to hear others experiences switching from one TNF-inhibitor to another.
A bit of background: I was diagnosed with RA 2 years ago, Prior to dx, my regular diet was already very close to recommended anti inflammatory diet - I ate healthy, and was physically active (lots of walking, hiking, kayaking). My initial RA flare came on very suddenly and was very severe, and progression seems pretty aggressive. I went the usual route of oral MTX (seemed to help initially then quit working), MTX subQ (seemed to help initially then quit working, plus I couldn't deal with the debilitating fatigue MTX caused). I next tried leflunomide (seemed to help initially then quit working.....hmmm, seems to be a pattern here!). I finally agreed to try a biologic, and had my first dose of Humira May 28.
Fast forward to today. My body does not like Humira. At all!! After 2 weeks of feeling so awful (my list of side effects reached 10 - I think I'd rather deal with RA pain!), my rheumy is switching me to Enbrel.
Which brings me to my question: both Humira and Enbrel are TNF-inhibitors. Meaning they have the same action in your system. So if you have an extremely bad reaction to one TNF-inhibitor, why wouldn't you expect to have the same reaction to another? I do have a call in to my rheumy to discuss with him (and it will be a while before pre-approval/prescription fill from specialty pharmacy, etc), but I'm curious about others who've had a negative experience with one (not just that it didn't work, but serious and/or multiple side effects) but not the other.
Sorry for the lengthy post. Helps to ramble in a setting where everyone understands the frustrations. Gawd I hate this disease!!
Hey Gatodelsol, About Enbrel and Humira...I am no expert by any means
but, these meds are made up of more than just the active ingrediant. Or the TNF. So it is probably the different combinations of ingredients that carry the active ingredient to where it needs to be to work that may cause a lot of the side effects and also they would be different side effects for different drugs. And would affect each person somewhat differently.
As I said, I am no expert (as you can tell by the terminology, or lack thereof
HI Gatodelsol! Thank you for sharing and please don't hesitate to come here anytime you need to vent, ask questions, or just process things. We are happy to help in any way we can. Freedom55 pretty much hit the nail on the head with her comment on the various treatments, including TNF treatments. Just like everyone experiences RA differently, they also react to medications uniquely. So, even though you have had a rough experience with Humira, it does not automatically mean you will have the same reaction to Enbrel. That said, it does seem that your body is not very fond of some of the more conventional RA treatments, but it sounds like you and your rheumatologist are aware of this and are being proactive about finding the best treatment option for you. Hopefully, Enbrel is a good fit for you! Here is a piece by one of our contributors that may resonate with you. She has also struggled to find the best treatment for her RA -- https://rheumatoidarthritis.net/living/starting-enbrel/. Also, here is a continuation of her story -- https://rheumatoidarthritis.net/living/switching-biologics/. For a time, Enbrel worked very well for her, but then she switched to Humira. So, different biologics may react differently in your system. Again, I hope Enbrel offers you some good, consistent relief from your symptoms. Keep communicating with your rheumatologist as you have more questions. A good doctor will welcome your questions and partner with you to manage your RA in the best way possible for you and your lifestyle. Thanks for reaching out and I hope this, along with Freedom55's input, help you feel a little more at ease. Best of luck and please keep us posted on how you are doing, if you feel comfortable doing so. Best, Erin, RheumatoidArthritis.net Team Member.
Hi Gatodelsol,
As you have been hearing the biologics each actually work differently inside the body. My wife, Kelly Mack (a contributor here) was switched from Enbrel to Humira and in this article about the experience she mentions how her doctor "explained that the two drugs have two different kinds of operating mechanisms for attacking the RA and that it was worth seeing if Humira helped" https://rheumatoidarthritis.net/living/switching-biologics/.
Biologics are made from actual living proteins and even those that act similar within the body are different (this is one of the reasons biosimilars have difficulty getting approval - they have to show that even though they act the same as the drug they are a similar to, they are in fact a similar, but different protein). This article from our editorial team explains some of the details on how biologics work: https://rheumatoidarthritis.net/treatment/biologics-treatment-options-for-ra/.
Please keep us posted on how the treatment goes and wishing you the best. Richard (RheumatoidArthrtiis.net Team)
Freedom55, Erin and Richard, thanks so much for your responses and all the great information! Everything you all shared makes perfect sense, and has been so helpful - I now feel much more comfortable about initiating the Enbrel. I have to confess I'm struggling with optimism (which in itself is incredibly sad, as I used to consider myself a fairly positive person). But, we do what we can when we can and take it one day at a time, yes?
Thanks again to all! What a wonderful resource this place is!
