Enbrel to MTX

[kemapicu]

Hi Guys,

Question for you all. My husband is currently on Enbrel. He started on E pretty much from the get-go, after discussing all options with his rheumy. He's been on it for 4 1/2 years, I believe. We did not try MTX because of the probability of birth defects. Though I was on the pill, there is no way I could have made the decision to abort if for some reason it failed and I became pregnant.

Long story short, now I am pregnant. He was on Enbrel at the time, and no data exists, as far as I know, about the daddy being on E at conception. Does anyone else know? This pregnancy was not exactly planned, but it is welcome. :) Thank goodness he wasn't on MTX.

Next question, what would be the advantages of switching to the MTX now that I am pregnant and that reason no longer exists. We are comfortable talking to his rheumy about it, but I like to be armed with info. What are your experiences on MTX vs. Enbrel? In addition, the E doesn't seem to be working as well as it used to work. In the beginning, he scaled back from the 25 mg 2xweek to splitting it to 1 1/2 weeks for 25 mg. Now, especially after going off the E and onto prednisone while we were actively trying to conceive, and returning to the E (change of conception plans) it seems to be much less efficient even while using the 25 mg 2xweek. He manages the pain with tylenol or naprosyn, but if he is not on pain meds, he rates his pain as 3 of 10, ongoing. Not good.

Thanks for all the input!

Keith and Martha Crawford
martha@simerson.net

[RichJ]

hi matha,
sorry i can't help much but i can bump you back to the top. some one will come through with great info. i wish you all the best

have a good day all

richard

[tmartha]

Hello, Crawfords, welcome - and congratulations on your baby to be! :) I'm sorry I don't have any answers for you - but I wanted to let you know it's an especially quiet weekend on these boards because many members (100+?) are at Capitol Hill Day today and Monday, raising awareness about psoriasis and pa and the need for research/funding. We should start hearing from more people by Tuesday.

That said, I'm sorry to hear the Enbrel is less effective for you, Keith - but I'm sure you'll find something that will. Asking here is a great idea - just keeping posting! You're sure to get some information soon. :)

Tani

[patti2957]

Hi and to echo TM, congratulations! Mtx is usually a first-line treatment because it's inexpensive and relatively reliable; when mtx isn't effective enough, a biologic is introduced. That's how it went for me, mtx for 7 months and when I still needed prednisone to function, my rheum prescribed Humira, which has very recently been approved for PA. A lot of people here have switched and seem to be having very good luck. Since he's already had success with a biologic I can't imagine going to mtx; you may want to ask about Humira. The side effects I've had from mtx include fatigue to the extreme, especially the day or two after taking it (once weekly). If I could go straight to Humira, that's what I'd do!
Good luck and keep us posted!
patti

[fire]

hi all realy new here.I was put on mxt and embrel.Was just on mxt at first it seam to work for a little 20mg. weekly.Then we added Emberl to the mix at first 2 shots at 25mg.now i do 1 50mg. oncea week.been doing this for 4 years now.the 50mg. have been doing this now for one now!!!Oh ay i did mxt pill first got real sick doing it that way.Was on the pill for 1 1/2 years!!!!! bad stuff bye for now

[kemapicu]

Hi guys, and thanks for the feedback. Keith is the one who brought up maybe going onto MTX to see if that helps. I was a bit reluctant because of the side effects. When we first found out about the PA monster, we talked with our rheumy, who is wonderful, by the way. She is the one who got our insurance to bypass the MTX treatment and go straight to the Enbrel. (apparently Keith can't control his alcohol consumption ;) and thus MTX wouldn't do well with his liver... who knew?) So I don't think that she would have a problem with switching it to Humira if we asked about it. I also recall her talking about maybe doing remicade awhile back.

Does MTX do anything to halt the progression of PA or does it only treat the symptoms? That was another concern that I have. Also, how much is Humira in relation to Enbrel? We have insurance, so I guess it doesn't amtter, but I was curious.

[patti2957]

Yes, mtx is a dmard, which is why they make us take it along with anti-inflams - ha. But, since biologics control the disease I'd try Humira first. Does your husband have fatigue issues? The kind of tiredness from being pregnant is the closest to this kind of fatigue I've ever experienced. And, the Humira is starting to help - yay!
With no insurance, a 2-syringe package is $1600, which is so totally hard to believe. It depends upon your copay, of course, and mine has been getting higher every year; I have to pay $60, but it's for a month's supply so that isn't so bad.
How are YOU feeling, by the way? :)
patti

[kemapicu]

It's hard to tell if he is fatigued. He can fall asleep at the drop of a hat and has since I've known him (~10 years). I think that he is more tired than normal, with less drive, or motivation, but he doesn't really notice so much.

I, on the other hand, notice fatigue. :rolleyes: I'm tired ALL the time. I've never been a nap taker, but I'm seriously considering becoming one... if I can find the time. Other than having to pee all the time (about once every two hours!) and being tired, I'm doing well. No morning sickness yet! I hope that remains the case for the next two months! :D

The price is really comparable to the enbrel then. Not too much surprise there. When we go back to the doc's I'll ask her about Humira and see what she thinks. I'm fairly certain she will want to get Keith the best treatment possible. And she'll be EXTREMELY excited about my pregnancy. Every time I go to an appt with him she asks if we are pregnant. She may just faint this time. ;)

Glad the humira is working for you!

Martha

[patti2957]

I don't know what it was about this article that I found appealing, maybe the frank discussion of what some 'sources' make very iffy sounding, or maybe just not very sympathetic. I have a lot of guilt about being fatigued because it's not quantifiable, I guess, and because I'm still working on the whole, "gee, you mean I can't control this??" issue. You'd think being pregnant (8 & 10 years ago) would have taught me that:) and the lessons never stop. I treasure my children and when I felt like I'd given up everything to this disease last summer, after being dx and starting on the mtx, which wiped my slate for the first few months, being there with and for them created meaning in a whole new way.
Enjoy every day, even the times you have to give in and rest; oh, and read as many books as you can:)
best wishes,
patti

http://arthritis.about.com/od/fatigue/a/tiredbeingtired.htm