Which TNF-alpha inhibitor to choose?

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mlatida
Regular Member


Date Joined Aug 2010
Total Posts : 129
   Posted 8/16/2010 3:37 PM (GMT -7)   
Anyone have experience with Enbrel (etanercept), Remicade(infliximab) or Humira (adalimumab)? I have to pick one of these TNF-alpha inhibitors for management of my Crohn's disease.

History:
Diagnosed 2 years ago- no surgeries
Intolerant to azathioprine. Have been on methotrexate for ~1 year. Minor break-thru symptoms on methotrexate; however, no increase in inflammatory markers until recently. Now suffering a severe Crohn's flare.

ivy6
Elite Member


Date Joined Sep 2005
Total Posts : 10404
   Posted 8/16/2010 3:45 PM (GMT -7)   
Not Cimzia? I'm surprised to here that Enbrel has been offered and not Cimzia...
Co-Moderator Crohn's Forum.

Medications for Crohn's ~~ Diet and Nutritional Therapy for Crohn's ~~ Dealing with Abscesses and Fistulae ~~

mlatida
Regular Member


Date Joined Aug 2010
Total Posts : 129
   Posted 8/16/2010 3:52 PM (GMT -7)   
Maybe it was Cimzia. I've been so consumed with trying to get healthy and not worry about losing my job. Plus, the doctors talked to me right after my colonoscopy- Like I'm going to remember much of that?!?!
Diagnosed with Crohn's disease March 2008. Battled a C. diff infection from Summer 2009-Spring 2010. Have been dealing with a severe flare for the past several weeks.

ivy6
Elite Member


Date Joined Sep 2005
Total Posts : 10404
   Posted 8/16/2010 3:56 PM (GMT -7)   
Don't you hate it when they do that? It's so unfair, and wrong.
Co-Moderator Crohn's Forum.

Medications for Crohn's ~~ Diet and Nutritional Therapy for Crohn's ~~ Dealing with Abscesses and Fistulae ~~

mlatida
Regular Member


Date Joined Aug 2010
Total Posts : 129
   Posted 8/16/2010 4:36 PM (GMT -7)   
I'm a grad student so I don't have much time or money, although I will make the effort for my health. What advice can people give me about cost, risks, and side effects to help my decision between the TNF-alpha inhibitors for Crohn's disease?
Diagnosed with Crohn's disease March 2008. Battled a C. diff infection from Summer 2009-Spring 2010. Have been dealing with a severe flare for the past several weeks.

dawinner
Regular Member


Date Joined Apr 2010
Total Posts : 29
   Posted 8/16/2010 7:39 PM (GMT -7)   
what do you mean by minor break thru symtpms?
21 year old male, Diagnosed with Crohn's in Feb 2010.
Previous Meds: Prednisone, Pentasa. Meds did not work apparently and inflammation became more extensive so I had to start on the current meds. 
 
Current Meds: Remicade (done 1 infusion) and Azathioprine 125 mg. Have been symptom free for 2 months even before the Remicade and Azathioprine.
 
Trying to eat natural foods, avoiding red meat, dairy, spicy, fried foods and refined sugar. Interested in trying to figure out if there is a way to get off medicines and achieve/maintain remission with diet.

ivy6
Elite Member


Date Joined Sep 2005
Total Posts : 10404
   Posted 8/16/2010 7:43 PM (GMT -7)   
Mlatida, you may find that the reason few people are replying is that they have answered many, many, similar questions in the past and are getting tired and burnt out.

Try searching the forum; looking at the medications link in my signature, and the new meds thread that I'm updating (should be on hte first page or two of the forum), and the things you find should help guide you in your decision.

Ivy.
Co-Moderator Crohn's Forum.

Medications for Crohn's ~~ Diet and Nutritional Therapy for Crohn's ~~ Dealing with Abscesses and Fistulae ~~

lero3645
Regular Member


Date Joined Feb 2010
Total Posts : 21
   Posted 8/17/2010 2:35 PM (GMT -7)   
I have had terrible side effects when I was on Remicade. I got drug induced psorasis. It started eight months ago and it looks like I now have a lifetime of psorasis on my hands to deal with on top of the crohn's. However, it is a very rare case and is very uncommon. But it was so scarring I try and tell people to try everything else before going on such a serious drug like Remicade. Good luck!
Everything in moderation, be thankful everyday, and be the most honest I can be. If I can look in the mirror at the end of the day and say I have done these things, I am happy.
 
Drugs I have tried: Pentasa, Entocort/Imuran, Prednisone, Remicade
 
Drugs I am on: None for Crohn's, Predisone for drug induced Psorasis
 
What I need: A bowel resection

Tara28
Regular Member


Date Joined Apr 2005
Total Posts : 362
   Posted 8/17/2010 7:42 PM (GMT -7)   
I got bad psoriasis with HUmira. I called the hotline several times to report it and wa told things like it "was not possible" and "just fluke timing". I KNEW it was the Humira. I also noticed it was listed as a possible side effcet of Cimzia (front page and centre of their website). Finally the Humira people have gotten enough reports I notice they FINALLY acknowledge it on their site as well.
I haven't been on Cimzia, but I have been on remicade and humira. Although neither one helped heal my fistulas, I felt that I preferred the Remi by far. I felt the humira was a waste of time (for me) . The humira is also uncomfortable when injecting. The remicade is not painful when being infused but it can take 4-6h out of your day (but only every 6-8 weeks I think, can't remember the schedule) so in that sense the humira is more convenient. Also, the remi has a slightly higher chance of allergy becasue it's mouse derivative.
  On the other hand, remi was invented first, and the humira people basically pirated remi's idea and tried to market an injectable as way better, trying to syphon remi's profits (while passing on none of the savings- all these companies have an agreement with each other to charge the same $$ )
Personally I still vote for remicade.
33 years old, dx with Crohn's in 1998. Currently on :
Clofazimine 100mg daily,
Rifampin 600mg daily, and Clarithromycin 2 tabs daily
and Cipralex 10mg/day for anxiety.
Hydroxyzine, percocet, Ativan as needed.
5g pharmaceutical grade Omega 3's, 1000IU's Vitamin D3 daily
2 Perianal fistulas, and 1 more suspected. Crohn's only at end of colon, cecum. Remi, Asacol, Salofalk, Imuran, Humira did nada. Built immunity to long-term Cipro use, which also induced panic attacks.

ZenaWP
Veteran Member


Date Joined Aug 2007
Total Posts : 884
   Posted 8/18/2010 9:49 AM (GMT -7)   
Enbrel isn't approved for Crohn's and doesn't seem to help any (based on current research), so Cimzia was probably the other option.  Cimzia and Humira are both very comparable in my opinion and both have co-pay assistance plans that will cover all or most of your copays.  Both are much more convenient than Remicade and cheaper.  Remicade has been around longer and has more data behind it, but I had allergic reactions on it.  The last time I took it, it had to be infused over 19 hrs in the hospital (every 6 weeks) so I wouldn't react to it.  Lost response and  decided that combined with the allergic reactions, needed to stop it.  All 3 drugs kept my Crohn's in remission but none have helped enough for the arthritis. 

Crohn's Disease with Arthritis, Non-Erosive Reflux Disease, Gastritis, Hashimoto's Thyroiditis, Endometriosis, Depression/Anxiety 

Tara28
Regular Member


Date Joined Apr 2005
Total Posts : 362
   Posted 8/18/2010 4:06 PM (GMT -7)   
wow, a 19-hour infusion? That would get old fast. No wonder you prefer the Humira! :)
33 years old, dx with Crohn's in 1998. Currently on :
Clofazimine 100mg daily,
Rifampin 600mg daily, and Clarithromycin 2 tabs daily
and Cipralex 10mg/day for anxiety.
Hydroxyzine, percocet, Ativan as needed.
5g pharmaceutical grade Omega 3's, 1000IU's Vitamin D3 daily
2 Perianal fistulas, and 1 more suspected. Crohn's only at end of colon, cecum. Remi, Asacol, Salofalk, Imuran, Humira did nada. Built immunity to long-term Cipro use, which also induced panic attacks.
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