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,” “not enough 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.

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.

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.

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.

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.

 

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The RheumatoidArthritis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here. It is important that you speak with your doctor/health care professional before stopping or changing any treatment plan.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The RheumatoidArthritis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

View Comments (8)
  • gsehealth
    3 months ago

    My mom was not taking medicines regularly. That is why Dr. has suggested Biologics this time. Please suggest, what should we do?

  • Kelly Mack moderator author
    3 months ago

    Hi gsehealth, sorry to hear about your mother. Biologics also require them to be taken at the right day so not sure that will make a difference for the problem. If it is an issue of remembering, I set alarms for myself to remind me to take medications. Perhaps this would help? Best, Kelly (RheumatoidArthritis.net Team)

  • gsehealth
    2 months ago

    Thank You

  • MikeinOZ
    1 year ago

    Hi from Australia! My former rheumatologist retired a few years ago and i have a younger guy who seems to have a scholarly knowledge, but not always a practical one. I’ve been on all the non-biologics with some relief, but not stopping erosion. I have a collection of other things, including fibro and chronic sinusitis. My main problem areas are my hands and hips, but feet are also involved. A big toe is fused and my feet are swelling. Fatigue has been a big factor for me, plus cognitive fog. Things were pretty OK, allowing that some degree of pain was there all the time. Little over a year ago my rh. wanted me to go on Enbrel, even though i had chronic sinus infection. I tried it for a few months, but saw little improvement. I stopped. But later last year he asked me to give it one more try. I did, but my sore throats are not just at night, but all day, plus my fatigue is terrrible. I just want to sleep. My hand swelling seems more related to usage than the Enbrel! Warmer weather here doesn’t mean joints feel better, but feel worse because i try to do more odd-jobs around the house etc! With our subsidised health system, Enbrel is the only approved biologic and I’m not sure Humira is available here. I want to give up the Enbrel anyway, cant see much benefit from it, but can’t see any alternatives. Any thoughts please?

  • Lawrence 'rick' Phillips
    2 years ago

    I hope this one does well for you. I have used seven and each is different. For me when I switch I write down a few things I like and disliked about my last one and a sentence or two about how I feel on the day of the switch.

    That helps me remember how things are 3- 5 months later.

  • Kelly Mack moderator author
    2 years ago

    Thanks so much, Rick–terrific advice! One thing I am liking is the injection mechanism. While it isn’t that much different, for some reason I have less bruises on average. Will make some other notes too. Appreciate it! Best, Kelly

  • Carla Kienast
    2 years ago

    Kelly: Switching biologics can be scary (I know — I’ve nearly tried them all). Each of them work a bit differently. Hopefully this one will get you back on track!

  • Kelly Mack moderator author
    2 years ago

    Thanks Carla! Happy to report that I am feeling better and my CRP came down. I need to go in for re-testing to see if things are still working. But fingers crossed! 🙂 Best, Kelly

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