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Medical Forum / Diseases and Disorders / Arthritis / June 2005

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Enbrel or Adalimumab

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NTL News - 24 Jun 2005 11:19 GMT
I wonder if any of you good folk could give me some advice/pointers.

My wife, who's had both RA and OA for many years has just been accepted onto
the AntiTNF programme.

She has been offered the choice of medications, but the rheumatology people
will not give any specific advice on which to choose. They have given her
leaflets etc. and told her to make her own choice.

As she wants to do home injections rather than travel to hospital a good
distance away, it seems to boil down to Enbrel (now, apparently, just weekly
injections) or Adalimumab (fortnightly injections). According to the
leaflets they both seem to have the same risk factors and effectiveness, so
an informed choice is difficult.

Any observations/advice from anyone who has already made such a choice - it
would be much appreciated.

Al
Keyhole Kate - 24 Jun 2005 14:44 GMT
Hello,
I had the same choice to make in December...........I chose Adalimumab
(Humira)mainly because the injections are every two weeks rather than
twice weekly.  I have never injected myself before and thought that the
fewer the better.  Everything has gone so well.  I have had no problems
with injecting myself, but am glad that I only have to do it
fortnightly.  I had a urine infection shortly after starting the
treatment which was successfully treated with antibiotics and have had
nothing since.  The benefits make the risk worthwhile in my
opinion.................quality of life is the most important factor.
Besides the leaflets there is a lot of information on the internet.

Kate

> I wonder if any of you good folk could give me some advice/pointers.
>
[quoted text clipped - 15 lines]
>
> Al
diclidophora@yahoo.co.uk - 24 Jun 2005 18:16 GMT
It is certainly more convenient to inject once every two weeks instead
of twice a week and given the choice I would personally choose Humira.
In fact I would change from Enbrel to Humira if I got the chance.

As far as I can judge there is not much difference in efficacy between
them. But there still seems to be some idiosyncracy.

Peter
Jayne - 24 Jun 2005 20:47 GMT
I'm an Enbrel user, and thank my lucky stars every day for it.  Life isn't
perfect with Enbrel, but it is zillions better than life was 2 years ago.

I've been on Enbrel for 2 years this month (how time flies eh!).  I can go
about my business quite well considering.  Two years ago, I couldn't scratch
the back of my own neck, or wash my own hair, as I couldn't raise my arms
and bend my elbows enough.  My hands look more normal than they did too.  It
can't help the damage already done - I've recently had one knee replacement
and am due the other later this year.

There are some of us here on Humira (Adalimumab), and a couple on Enbrel.

I really wish your wife all the best with her decision.  I worried over the
infection risk at first, but I've always been quite hardy as far as
infections go, and haven't had one in the two years I've been taking it.  In
fact, I don't think I've seen my GP since before the treatment started,
which has to be good!

Jayne
NTL News - 24 Jun 2005 23:32 GMT
> I'm an Enbrel user, and thank my lucky stars every day for it.  Life isn't
> perfect with Enbrel, but it is zillions better than life was 2 years ago.
[quoted text clipped - 13 lines]
> In fact, I don't think I've seen my GP since before the treatment started,
> which has to be good!

Thanks Jayne and everyone else who replied.

It seems that Enbrel now needs only to be injected once weekly, which is
better.

My wife is not too concerned about the frequency of injections, but more the
possible added risk of infection. Also we both wondered if with Humira,
since it is only injected fortnightly, there might be a 'drop off' in its
efficacy towards the end of the two weeks, but your replies so far have not
mentioned this, so it's probably not a problem.

It does seem that there is not a great lot to choose between the two
treatments.
My wife has just had a second knee replacement. The op went OK and the knee
itself seems fine, but since the operation she has a very swollen ankle and
foot which are giving her a lot of pain. Not sure that the consultant really
knows why, so it's wait and hope everything settles down. I wonder if it's
possible that the antiTNF treatment may help with the pain and swelling?

Anyway, thanks again,

Al
Jayne - 25 Jun 2005 21:46 GMT
I meant to add that I've just been offered the once a week jab!

Its funny y ou should say about the swollen ankle and foot, as I had that
after my knee op.  My foot swelled up when I got home on day 4 and I
developed the most spectacular black bruising on the side of my foot and
across my toes.  It lasted a week or two then subsided by itself.

Not sure if the anti tnf will help with that pain and swelling, but she
should keep it elevated as much as she can.

Jayne

> Thanks Jayne and everyone else who replied.
>
[quoted text clipped - 19 lines]
>
> Al
Robin Fairbairns - 26 Jun 2005 23:11 GMT
>Its funny y ou should say about the swollen ankle and foot, as I had that
>after my knee op.  My foot swelled up when I got home on day 4 and I
>developed the most spectacular black bruising on the side of my foot and
>across my toes.  It lasted a week or two then subsided by itself.

i nursed my mother after her first knee op (sharing with one of my
sisters).  it now turns out that the op was botched, but as well as
the appalling swelling of the knee, there was also some really bad
swelling of the ankle -- jayne's mention of the black bruising brought
back the memory of that ghastly time (i think i must have been
suppressing it).

mum's "better" now ... in some sense: she's still in an awful lot of
pain, and has just suffered a nasty reaction from something the pain
clinic gave her.

>Not sure if the anti tnf will help with that pain and swelling,

i can imagine a way it might, but i don't understand it well enough to
guess it would be so.  (note: they've taken me off evaluation for anti-
tnf because i'm "not ill enough".  interestingly, this was when my
peripatetic psoriatic arthritis had taken a dive for my feet, and was
letting my hands relax a bit ... and feet aren't part of the
evaluation for anti-tnf, here.  given the way it goes, i doubt i'm
ever going to be on anti-tnf, now.)

>but she should keep it elevated as much as she can.

that's what my mother did.  it went away eventually.
Signature

Robin (http://www.tex.ac.uk/faq) Fairbairns, Cambridge

diclidophora@yahoo.co.uk - 28 Jun 2005 15:42 GMT
I reckon with any op of that sort there is quite a lot of bleeding. The
blood would perhaps drain down to the foot later and cause swelling and
bruising. Elevating the leg will help to get rid of the swelling, but I
think also it would be advisable to do calf/leg muscle contractions and
exercise the foot as much as possible to counteract the possibility of
dvt.

Just a thought

Peter
Jayne - 28 Jun 2005 19:24 GMT
>I reckon with any op of that sort there is quite a lot of bleeding. The
> blood would perhaps drain down to the foot later and cause swelling and
[quoted text clipped - 6 lines]
>
> Peter

They told me that the swelling and bruising was a consequence of the
tourniquet, and the clamp that my foot was held in.

Jayne

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