Medical Forum / Diseases and Disorders / Arthritis / July 2005
Adalimumab (Humira) Failure
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baino - 11 Jul 2005 15:56 GMT Hi Everyone, Well I have just returned home after spending the last 5 weeks in hospital. I was accepted onto the anti-tnf progam in February and decided to choose Humira as it was 1 injection fortnightly, However, things went from bad to worse and I had a severe flare up of my RA and ended up back in hospital. As it turns out the Humira failed to work and my RA hit me like wildfire again. I think it was due to the body not absorbing it, but it was'nt confirmed and I didn't ask. I could'nt move in bed as I was in so much pain and had to have morphine injections to ease the pain and try and let me have some sleep. I could'nt wash myself or feed myself and the nurses were having to do all these simple things for me. I was in quite a bad way and they told me that I was one of the worst cases they had seen for quite some time. The first 2 weeks in hospital were a nightmare with morphine injections and having an allergic reaction to Tramadol painkillers as well. I also had 3 methyl prednisilone infusions to control the inflammation, this had a knock on effect in as much as my liver function went through the roof and they had to suspend some of my drugs inc MTX. They decided to stop the Humira and start me on etanercept (enbrel) and bearing in mind I've only been on it for 3 weeks it has made so much difference. I am relatively pain free apart from a few niggles I can live with. I have been having intensive physio and occupational therapy in hospital and will still have these at home also but I know its going to be a hard slog to get back to where I was but now I think I have the correct tools in the toolbox to continue in life so much happier and so much less in pain. Its a case of onwards and upwards from now on. I just wish that I had chosen etanercept in the beginning instead of humira but you just don't know. Another point worth mentioning is that Infliximab and Humira have the same chemical make up where as etanercept has a different chemical make up. This was confirmed by my consultant who told me that the failure rate for Humira was 1 in 7 and because i'd failed on that, that the failure rate if i'd been changed to infliximab would have been 1 in 3 so it was best to avoid that as well, that left only etanercept which has been a life saver. I'm on twice weekly injections at te moment but hopefuly will be changing to once a week after the weekly trials have been evaluated. Drugs work in different ways with different people but my advice for somebody faced with the decision of choice of anti-tnf would be to chose etanercept ahead of the others as it works wonders.
robert
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diclidophora@yahoo.co.uk - 11 Jul 2005 17:39 GMT Robert.
You have certainly been thr the mill. My sympathies and best wishes for the future. I think it is very interesting that you found there was such a difference between the anti tnf drugs which are often regarded as being very similar, at least in their disease modifying actions.
Peter
Jayne - 11 Jul 2005 17:48 GMT Hi Robert
I've never experienced what you've been through - have never been bad enough to be hospitalised, and your ordeal sounds dreadful.
I am really pleased that you have found some relief with Enbrel. I've been taking it for two years, and it has made a big difference to me. I had to add a little mtx in with it, but nowhere near a full dose. For me it works, but I've never tried the remicade or humira.
Fingers crossed that it continues to work for you!
Jayne
Jayne - 12 Jul 2005 19:38 GMT > Hi Robert > [quoted text clipped - 9 lines] > > Jayne I meant to add to my post last night but forgot!
After my 6 month monitoring visit a few weeks ago, I am changing over the the 50mg once a week injection. My rheumatology dept hasn't got anyone on the once a week schedule, so I said I'd try it out to see how it goes.
Will post results!
Jayne
Jayne - 12 Jul 2005 19:38 GMT > Hi Robert > [quoted text clipped - 9 lines] > > Jayne I meant to add to my post last night but forgot!
After my 6 month monitoring visit a few weeks ago, I am changing over the the 50mg once a week injection. My rheumatology dept hasn't got anyone on the once a week schedule, so I said I'd try it out to see how it goes.
Will post results!
Jayne
diclidophora@yahoo.co.uk - 13 Jul 2005 17:50 GMT I see mine on Monday and have requested once a week. It seems there is nobody here on it either.
He won't inject my swollen knee, so I don't know how this daring request will fare !
Peter
Jayne - 13 Jul 2005 21:24 GMT >I see mine on Monday and have requested once a week. It seems there is > nobody here on it either. [quoted text clipped - 3 lines] > > Peter I've never had a joint injected Peter - have you had it done before?
Jayne
Harvey R. Stone - 14 Jul 2005 15:17 GMT >>I see mine on Monday and have requested once a week. It seems there is >> nobody here on it either. [quoted text clipped - 7 lines] > > Jayne Hi Jayne, I have had several. The skill of the person giving the shot means a great deal. I have asked the doc when is he going to start when he was done and other shots that made me cry like a baby. The shot may be needed to remove fluid from a joint and test it for infection or just to put steroid in to control what is taking place. Harv
Jayne - 14 Jul 2005 18:01 GMT > Hi Jayne, I have had several. The skill of the person giving the > shot [quoted text clipped - 3 lines] > put steroid in to control what is taking place. > Harv Hi Harv (nice to see new posters!)
It isn't something that my doctor has ever offered, to be honest. I've had the steroid depo shot in the rear end when I was flaring badly once, but I think by the time my knees were bad enough to do something about, they considered that the "something" was a replacement or nothing.
Joint injections are one of those things that my mind sees as being "cringey", so it is reassuring that you have experiences ones which aren't.
Jayne
baino - 14 Jul 2005 23:44 GMT I'd like to add that I've had lots of steroid injections ranging from cortisone to kenelog etc in my elbows, knees, ankles, shoulders etc with varying degrees of success. I've also had fluid drained from my knees. My experience is that its painful only if the doctor giving it dosen't hit the sweet spot in the joint, also the initial injection is'nt sore but the actual injecting of the cortisone etc can be uncomfortable. I'd also like to add that in my experience the more times its been done the lesser the pain relief is, by that I mean it is'nt as effective as it was the first time. I've also had the intra-muscular (in the bum) ones with some success although in hospital I had 2 in 3 days with little effect. My advice to anyone is to have it done because it will alleviate the pain for a time however the more times its done the lesser the pain relief. I used to get up to 3 months relief but now if I'm lucky I maybe get a week or perhaps two. Thank god I've been put onto enbrel as its proving to be the best medication I've been prescribed since I was diagnosed with RA.
>> Hi Jayne, I have had several. The skill of the person giving the >> shot [quoted text clipped - 16 lines] > > Jayne Alison - 11 Jul 2005 22:02 GMT $0$2883$ed2e19e4@ptn-nntp-reader04.plus.net...
> Hi Everyone, > Well I have just returned home after spending the last 5 [quoted text clipped - 35 lines] > > robert>> Sorry you've had such a bad time but glad to hear the enbrel has made such a big difference. I'm on Enbrel and MTX . Alison
Robin Fairbairns - 11 Jul 2005 22:40 GMT >[horror story omitted.] Drugs work in different ways with >different people but my advice for somebody faced with the decision of >choice of anti-tnf would be to chose etanercept ahead of the others as it >works wonders. poor old you! here's to continued stability on etanercept, eh!
best wishes...
 Signature Robin (http://www.tex.ac.uk/faq) Fairbairns, Cambridge
baino - 12 Jul 2005 00:56 GMT Thank you everyone for your kind wishes, I know i've been through the mill and the doctors told me it would take possibly a couple of years to get back to where i was originally but i'm going to try and prove them wrong, however at the same time i'm going to be sensible and not overdo things. I still have to have lots of physio and OT for the foreseeable future but with 100% determination, i aim to improve. Another intresting point i'd like to make with regard to the humira is weight gain. I know this isn't a recognised side effect but i gained a little weight whilst on it and it wasn't a coincidence as i'd lost weight for 15 consecutive months then started humira and then began gaining weight for the next 3 months. The consultant was interested in this as quite a few others had been telling him the same thing. Anyway looking forward to another injection tomorrow, at least i'm getting a tattoo on my belly free of charge with the bruising.
robert
> Hi Everyone, > Well I have just returned home after spending the last 5 [quoted text clipped - 43 lines] > > which means you can download at 65.79 KB/sec. Ian - 12 Jul 2005 10:56 GMT trawlman@yahoo.co.uk wrote:
> Thank you everyone for your kind wishes, I know i've been through the mill > and the doctors told me it would take possibly a couple of years to get back > to where i was originally but i'm going to try and prove them wrong, however That's the right attitude! I was horrified to read your account, being a new comer to this arthritis thing; I had no idea it can be so bad. Free tattoo on your belly ....! Like it.
 Signature Ian Ft Worth, TX
me2@dn14.net - 12 Jul 2005 17:29 GMT >I had no idea it can be so >bad. Ian, In just the same way as different drugs can be effective or less so if different people, arthritis can "be bad" or less so on different individuals. I really feel for the orignal poster and am glad that Enbrel seems to be working now.
There are over 170+ types of arthritis:
Achilles tendinitis, Achondroplasia, Amyloidosis, Acromegalic arthropathy, Adhesive capsulitis, Adult onset Still's disease, Ankylosing spondylitis, Anserine bursitis, Arthrochalasis multiplex congenita, Aseptic necrosis, Asymptomatic hyperuricemia, Avascular necrosis, Bacterial arthritis, Baker's cysts, Behcet's syndrome, Bicipital tendinitis, Blount's disease, Bouchard's nodes, Boutonniere deformity, Buchman's disease, Buerger's disease, Bursitis, Calcaneal bursitis, Calcium pyrophosphate dehydrate (CPPD) crystal deposition disease, Caplan's syndrome, Carpal tunnel syndrome, Charcot-Marie-Tooth disease Childhood dermatomyositis, Chondrocalcinosis, Chondroma, Chondromalacia patellae, Chondromatosis, Chronic overuse syndrome, Chronic polymyositis, Chronic recurrent multifocal osteomyelitis, Churg-Strauss syndrome, Clawfoot, Clutton's joints, Cogan's syndrome, Connective tissue disease, Corticosteroid-induced osteoporosis, Costosternal syndrome, CREST syndrome, Crohn's disease, Cryoglobulinemia, Degenerative joint disease, Dermatomyositis, Diabetic finger sclerosis, Diffuse articular lipomatosis, Diffuse idiopathic skeletal hyperostosis (DISH), Discitis,Discoid lupus erythematosus, Drug-induced lupus, Drug-induced scleroderma-like disease, Duchenne's muscular dystrophy, Dupuytren's contracture, Dwarfism, Ehlers-Danlos syndrome, Enteropathic arthritis, Epicondylitis, Erosive inflammatory osteoarthritis, Exercise-induced compartment syndrome, Fabry's disease, Familial amyloidosis, Familial Mediterranean fever,Farber's lipogranulomatosis, Felty's syndrome, Fibromyalgia, Fifth's disease, Flatfeet, Foreign body synovitis, Freiberg's disease, Frozen shoulder, Fungal arthritis, Gaucher's disease, Giant cell arteritis, Gonococcal arthritis, Goodpasture's syndrome, Gout, Granulomatous arteritis, Heberden's nodes, Hemarthrosis, Hemochromatosis, Henoch-Schonlein purpura, Hepatitis B surface antigen disease, Hidradenitis suppurative, Hip dysplasia, Hurler syndrome, Hypermobility syndrome, Hypersensitvity vasculitis, Hypertrophic osteoarthropathy, Idiopathic osteonecrosis, Immune complex disease, Impingement syndrome, Jaccoud's arthropathy, Juvenile ankylosing spondylitis, Juvenile chronic polyarthritis, Juvenile dermatomyositis, Juvenile osteochondroses, Kawasaki disease, Kienbock's disease, Legg-Calve-Perthes disease, Lesch-Nyhan syndrome, Libman-Sacks endocarditis, Lightchain disease, Liner scleroderma, Lipoid dermatoarthritis, Loffler's syndrome, Lofgren's syndrome, Lyme disease, Malignant synovioma, Marfan's syndrome, Medial plica syndrome, Metabolic bone disease, Mixed connective tissue disease (MCTD), Mixed cryoglobulinemia, Morquio syndrome, Morton's neuroma, Mucha-Habertnan disease, Multiple epiphyseal dysplasia, Munchausen's syndrome, Myasthenia gravis, Mycoplasmal arthritis, Myofascial pain syndrome, Neonatal lupus, Neuropathic arthropathy, Nodular panniculitis, Ochronosis, Olecranon bursitis, Osgood-Schlatter disease, Osteitis defortnans, Osteoarthritis, Osteochondromatosis, Osteogenesis imperfecta syndrome, Osteomalacia, Osteomyelitis, Osteonecrosis, Osteoporosis, Overlap syndrome, Pachydermoperiostosis, Paget's disease of bone, Palindromic rheumatism,Patellofemoral pain syndrome, Pellegrini--Stieda syndrome, Periarticular abnormalities, Peroneal tendinitis, Pigmented villonodular synovitis, Piriformis syndrome, Plantar fasciitis, Polyarteritis nodosa, Polymyalgia rheumatica, Polymyositis, Popliteal cysts, Popliteal tendinitis, Posterior interosseous nerve syndrome, Posterior tibial tendinitis, Pott's disease, Prepatellar bursitis, Progressive systemic sclerosis, Prosthetic joint infection, Pseudogout, Pseudo-Hurler polydystrophy, Pseudohypoparathyroidism, Pseudoxanthoma elasticum, Psoriatic arthritis, Pyogenic arthritis, Raynaud's phenomenon, Reactive arthritis/Reiter's syndrome, Reflex sympathetic dystrophy syndrome, Relapsing polychondritis, Renal osteodystrophy, Retrocalcaneal bursitis, Rheumatic fever, Rheumatoid arthritis, Rheumatoid vasculitis, Riley-Day syndrome, Ross River virus,Rotator cuff tendinitis, Sacroiliitis, Saddle nose deformity, Salmonella osteomyelitis,Sanfilippo syndrome, Sarcoidosis, Saturnine gout, Scheie syndrome,Scheuermann's osteochondritis, Scleroderma, Septic arthritis,Seronegative arthritis, Shigella arthritis, Shoulder-hand syndrome,Sicca complex, Sickle cell arthropathy, Sjogren's syndrome, Skeletal dysplasias, Slipped capital femoral epiphysis, Sly syndrome, Spinal stenosis, Spondylolysis, Sporotrichosis Arthritis, Stickler syndrome, Still's disease, Sub-Achilles bursitis, Subacute cutaneous lupus, Swan neck deformity, Sweet's syndrome, Sydenham's chorea, Syphilitic arthritis, Systemic lupus erythematosus (SLE), Takayasu's arteritis, Tarsal tunnel syndrome, Temporal arteritis, Tendinitis, Tennis elbow, Thoracic outlet syndrome, Tietse's syndrome, Toxic oil syndrome, Transient osteoporosis, Traumatic arthritis, Trochanteric bursitis, Tuberculosis arthritis, Arthritis of Ulcerative colitis, Undifferentiated connective tissue syndrome (UCTS), Urticarial vasculitis, syndrome, Vasculitis, Viral arthritis, VonGierke's disease, VonWillebrand's disease, Weber-Christian disease, Wegener's granulomatosis, Whipple's disease, Wilson's disease, Yersinial arthritis.
If I missed any have a word with the Rheumatologist about it....
-- Andy
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