Switching Biologics

This past year has been a tough year for my rheumatoid arthritis. I started feeling worse early in the year, but kept rationalizing that “it was the weather,” “too much stress,” “sleep,” or a myriad of other reasons.

When I saw my doctor in February, I thought I was having a temporary flare and he prescribed some extra prednisone. That did the trick! (Oh how I love extra prednisone!) But as soon as I tapered off, I was back to feeling miserable.

A negative change in RA symptoms

It really hasn’t been the stiffness and the pain that has been the worst. (Don’t get me wrong, those things are terrible.) It has been the exhaustion. I have had even more trouble than usual with getting up in the morning, keeping my energy going throughout the day, and maintaining a relatively normal schedule. Increasingly, I have been spending more of my weekend hours in bed or resting than I usually do.

When I didn’t pick up my usual verve with the arrival of summer, I knew something more persistent was happening with my RA. Summer is typically my best time and I still struggled with the blahs.

My RA treatment no longer worked

So after more tests and a couple visits with my rheumatologist, I concluded that my drug regimen was no longer as effective. My CRP (inflammation indicator) was rising while I was feeling worse. Although we increased my methotrexate, the positive results were limited.

For the last two and a half years, I have also been taking a biologic for the first time. My health history has been complicated so this was the first time I tried it and I found it to be helpful. We started me on Enbrel because it was the oldest and most studied, and had helped a lot of RA patients.

Unfortunately, I have also read and heard from patients that sometimes the effectiveness of a biologic can fade over time. One person said they eventually tried all of them and while they worked for a while, after time it stopped helping.

Switching RA biologics

I had obviously hoped that the effectiveness would not fade, but it is known to happen. Thankfully, this is not everyone’s experience. My uncle has psoriatic arthritis and has been happily taking Enbrel for 10 years. He calls it a game changer and says it still works well for him.

Not long after I started taking Enbrel, I felt positive effects for my RA. Unfortunately this year I experienced more RA symptoms and with a little experimenting on my regimen, concluded that the Enbrel no longer worked as well as it had. So what to do?

After discussions with my doctor, I opted to try Humira. He 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. We could always go back to Enbrel, if I felt no better.

Too early to know if the switch helped

While I was anxious about the change, the switch has been very smooth. While Enbrel was a weekly shot, Humira is every other week. I kind of like having less injections! The auto-injector pens are not too different and it was not complicated to learn the new process.

Unfortunately, it is still too early to know if Humira will help with my RA but I am hopeful. In my case, I am not looking for a life changing medication, but something that will help me manage symptoms a little better. I have a lot of RA damage that I live with already and my goal is to minimize further damage. What would truly be great is to have a little more energy and make my fight against fatigue a bit easier. I am truly thankful to have choices of biologics that I can try.

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