Etanercept

Elmbow

I have just been diagnosed with psoriatic arthritis. Sulfasalazine wasn't helping much so I am being put on etanercept. I also take hydroxychloroquine.

Anything I should know? Will I need blood monitoring during treatment and which tests/how often? And how long before I actually start the drugs? There seems to be a process to go through first but no sense of whether that means weeks or months. And do I need a shingles vaccine?

dreamdaisy

I am surprised (and not a little envious) that you are going straight onto the anti-TNFs, I had to fail on three DMARDs before I was considered (four including sulph which I took all the time). I guess things improve the more people learn, luckily thousands of us have provided the required experience for others' benefit.

I took it for a while, a right old performance it was too but, as I said, thing have improved and I believe it now comes in pen form. I had fortnightly blood tests (which I had been having for years) and, if my memory serves me right, had lung function tests too due to being asthmatic. I cannot remember the timescales but it was a case of weeks rather than days, also I have no idea about whether a shingles vaccine is required but a flu jab is always helpful. I hope it works better for you than it did for me, I am sure the earlier one has these things the better the outcome can be. Good luck, please let us know how you get on. DD

jennand

I have just started on it. I had to have the usual blood tests first ( Crp, esr renal, liver etc. Plus hepatitis and TB bloods. Also had to have a chest X-ray. Only when all these came back clear would the hospital order the injections from Healthcare at home. For the first 12 weeks, I have 4 weekly deliveries which are only generated when I have my 4 weekly blood test. This will change then to 8 weekly dependant on my blood tests. The Healthcare nurse visited me at home and she gave me all the information I needed, then taught and supervised my first injection. She came back the second week. I started the injections each Thursday, but I am gradually extending it by a day as I am going abroad to a wedding soon and don’t want to take the injection with me. It’s OK to miss a week or 2 but I didn’t really want to do that so early. It is in pen form, so easy to do, not really like giving an injection. The brand that I have is called Enbrel. It is the newest form and comes in a quite large pen but this is fine for me because it makes it easy to grip. I was a nurse in my previous life and at the end of my career I found it increasingly difficult to draw up and administer injections because of RA in my hands, so the size of these pens is actually well designed. 6 weeks in and I’m feeling OK. Apparently 12 weeks is the testing time to see if it has any beneficial effects. The lovely weather at the moment suits me so it’s difficult to say if the drug or the weather is responsible but up to now, not any any flares or side effects. Hope this all helps.

BettyMac

Having been through all the preliminary tests which jennand described - I'm about to start on Benepali next week. It's a biosimilar of etanercept.
I just got things sorted with Healthcare-at-Home last week.

I was wondering about routine monitoring too. I'll still be on methotrexate so would need regular bloods done for that anyway.
Do you get your blood done at the GP, jennand?

I'm also wondering if I should contact my rheumatology dept because, after a few nasty flares in the latter part of last year and for most of this year so far - I'm now having a really good spell (touch wood). Have even managed to get some proper gardening done and am feeling more like my old self than I have in years.
I think, at heart, I know it's only a matter of time before the dreaded disease rears its ugly head again. And every time I flare it affects more joints and lasts longer.
Will discuss with the nurse when she's here next week as the stress of trying to make contact with the hospital dept will definitely set me off again.

I hope the biologic does the trick for you, Elmbow and jennand.

Edited to add:
I've just remembered the massive shot of depomedrone I got in my bahookey a few weeks ago. The improvement will be down to that and the benefits will wear off over the next couple of months.
I've just answered my own question
😊

jennand

Betty, I did used to get my bloods done at my GP but I had to have a couple of them repeated because the potassium was raised. My husband had the same thing but he was referred straight to hospital because he has heart disease. When there, his bloods were OK. It was decided that it was because his bloods were taken at the surgery and not sent straight away to the lab ( courier only comes at lunchtime). It seems the blood degrades too much. When the same thing happened to me, I decided that I would have it done at the hospital in future.

jennand

BTW Betty, my Rh nurse sent several blood test forms out to me to take to the hospital.

Elmbow

Thank you both. I assume I will be getting Benepali too if all goes ahead.

I had a chest x-ray and an armful of blood tests after my rheumatology appointment on Thursday and was just waiting for them to get the go-ahead and then have my first appointment with the nurse. But today I got a hospital appointment through that I wasn't expecting - I'm to go and see the respiratory medicine clinic at the hospital next week. No idea why.

Good luck to you two as well!

BettyMac

“An armful of blood tests”

I know! I counted eight phials being filled - four times the usual.

Good luck next week at your appointment. Let us know how it goes.

dreamdaisy

Respiratory will probably be for lung function tests, perhaps they are generally used for these meds and not the preserve of the asthmatic. DD