Humira Effectiveness

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elcamino
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Date Joined Sep 2005
Total Posts : 1744
   Posted 1/17/2006 5:42 AM (GMT -7)   
Hi all.  I've started Humira injections--it's been about 6 weeks.  I was put on it for RA, but now Rheumatologist and GI doctor suspect IBD (it's only my large joints that give me problems, especially my hips).  I usually have one good day immediately after an injection, but then my joints go back to throbbing.  How long does it take before I should start seeing some effects from the Humira?  My rheumatologist said 8 weeks I should start seeing some improvement, although it could be several months before it reaches its full effectiveness.  If I don't feel any improvement after 8 weeks (2 more weeks), he's suggesting switching to Remicade.  Is eight weeks a long enough trial for Humira?  Should I give it longer?  Is Humira less effective as monotherapy? 
 
thanks for any info.
Elcamino

erin.K
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Date Joined Mar 2005
Total Posts : 3148
   Posted 1/17/2006 11:59 AM (GMT -7)   

hey Elcamino,

what you could try is asking about Humira shots that are every week.  I take mine every 4 days for RA because I told my rheummy that "I feel a difference the few days after...but it does not last 14 days" So that is an option.

Been on Humira since August.

Honestly, I would give it a little while longer & inquire about a more frequent dose.

Give that a little time & if not satisfied perhaps an adjunct med to go with it.

Remicade could be the answer...I'm playing that deck of cards right now.

i wish you the best.

erin

 


erin.K
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Date Joined Mar 2005
Total Posts : 3148
   Posted 1/18/2006 9:44 PM (GMT -7)   

hey there,

just wanted to get back to you again.  while on Humira, as an adjunct...methotraxate can be added as well as Imuran too.  so you have 2 options that you can move on to if you are really unhappy with the way things are going. i'm sure there are more as well.

i saw my GI today (crohns and RA, with RA pain the major problem) and he told me to really really let the Humira have some time (i too was pushing the Remicade as was the rheummy).  he said with weekly Humira injections along with Imuran @ 50mg a day, the combo will actually "help each other out" and help the meds to work better.  he said for me to NOT LOOK FOR IMMEDIATE results: the suppossed 8 to 12 weeks to feel a difference.  i have been on Humira since august; yet the joints are getting worse.  been on Humira weekly for one month & just started Imuran friday.  GI guy said that a realistic expectation for a "noticeable" difference...was to look about March. 

but everyone is different ya know?  maybe YOU will have quicker results....maybe not.

do you feel as if Humira alone has DONE ANY GOOD as of yet?

i hate this as much as you do! feels like i've been waiting a decade (umh...wait, i have been!)...and each year goes by and it's the same thing.  i say every summer, "oh, next summer will be soooo much better i know it...."  and before i know it, 5 summers have gone by! and no better.

yet, the RA i have was neglected for many years.  but if yours was caught early...you may have a better and more successful road.

so look up the Imuran and Methotrexate and talk to your GI and rheummy about it.  i'm sure they'll be willing to try if you feel you are not making the progress you want.

i wish you all the best in the world!

please, when you get time let me know how you're doing.

erin


elcamino
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Date Joined Sep 2005
Total Posts : 1744
   Posted 1/19/2006 7:47 AM (GMT -7)   

Hi Erin.

thanks for checking back with me.  Everything is just the same, and holding.  At least it's not getting worse.  I see my rheumatologist the week after next, and that's when I'll decide to stick with Humira or move on to remicade.  I also get one more dose of Humira next week, so we'll see what happens.  I'm not overly fond of methotrexate, for the simple reason that I'm not ready to close the door on having more children.  Me and my dh struggled with infertility for years prior to having our twin daughters (they are now 3), and my rheumatologist told me if I started methotrexate I would have to use birth control.  I only have a small window left (I'm 37 now) for conceiving, but there is still a chance, even without actually trying.  How is Imuran with fertility/pregnancy?  I realize most of these drugs are not good during a pregnancy (I would certainly stop taking them), but will Imuran interfere with fertility, or cause such drastically severe effects on a fetus early on so that a woman would have to abort? 

I can talk to my rheumatologist about upping the Humira dose, but I'm not sure he would agree to do that.  You see, my doctors now believe that I don't have RA, but I, instead, have the nonerosive arthritis associated with IBD (even though I don't have a definitive diagnosis of IBD yet).  As such, rheumatologist feels my symptoms are mild (granted they are compared to some of his patients that have deforming arthritis), and may not warrant a higher dose of a biologic.  My arthritis symptoms may be nonerosive, but I can tell you that I still hurt.  I can ask my GI doctor about it too.  I got the impression that rheumatologist would like GI doctor to take over complete care of the Humira so he does not have to monitor me. 

In the meantime, I am taking Ultracet, although I only allow myself one a day.  I'm terrified of becoming addicted. 

Elcamino

 


erin.K
Veteran Member


Date Joined Mar 2005
Total Posts : 3148
   Posted 1/19/2006 3:25 PM (GMT -7)   

Awe, you've got quite a few issues on your plate.  Weighs heavily on the mind.  Really think about giving the Humira some more time.

See, I say this because I had a BIG heart-to-heart with my GI doc yesterday.  You know when you can tell when a person truly cares and is concerned with someone?  Well that's my GI doc.  He knows how miserable I am and how bad the RA is getting and my frustration with previous failed TNF's and all other drugs for arthritis.  And he knows I want to get the ball rolling with the Remicade because I want THIS TO END!  I'm not living...there is no quality of life going on here.

But he made this analogy: "Once you start Remicade infusions, there is no going backwards.  It would be like walking up a flight of stairs and with each step, the previous stairs falling behind you...once you get to the top, there's no where else to go."  Meaning that jumping too soon into this without exhausting completely all other options would be like going to the ER and them saying....SORRY WE CAN'T HELP YOU.  It's very difficult to go back to a Humira type med after Remicade if it should not work or if you cannot tolerate it.  Just something to think about.

8 or 12 weeks on Humira or an Enbrel med may seem like an eternity to wait for a result....but it's really not.  But then again...you know yourself the best and you might have a gut instinct that is leading you to the right decision you know?

This in all is just a very difficult situation.

If you are to start Remicade, you have to be on the Imuran for up to 3 months.  Takes a while for the Imuran to reach a therapeutic blood level.

Using a higher dosage of Humira is very effective for RA and also Crohns and inflammatory bowel diseases. (The Imuran also benefits and helps control crohns)  I've read people post of their doing loading doses of Humira of like 160mg! Whoa!  It truly cannot hurt to ask about more frequent injections...the worst they can say is NO, let's do the Remicade!

***From my knowledge...Imuran does not decrease fertility, but it is secreted in breast milk and will cross into the placenta.  It is contraindicated in pregnancy and lactation.  I would think that if you told your doc that you are trying to conceive, perhaps they would hold off on the medication.  Also, it may be harmful to a fetus too.  So contraception would be needed before and then 4 months after therapy is discontinued. 

I wish you well.  Listen to your heart, it won't stear you wrong.

Erin

  

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