Biological medication

bikingviking

Hi all, I was diagnosed after 9 month of Methatrexate that just was not good for me, I have been prescribed a biological, medicatio called Adalimumab Amgevita, and I am just about to take my 5th injection tomorrow. It’s taken ev two weeks, I.e. i have taken it for 8 weeks. So far I have not felt any improvement almost the opposite, I feel really bad right now. Has anyone got some experience of how long it takes for this medication t take effect? I also take 200mg/day of hydrochloroquine.

I look forward to hear from someone who also takes this medication or has taken it and stopped … if so why?

[Deleted User]

Hi @bikingviking,

Sorry to hear that you are feeling so rough and that your medication doesn't seem to be making much difference yet. I haven't had any experience with this particular medication personally but there will be plenty of people on our wonderful forum who have so they may be able to offer more advice.

You could always discuss other possibilities with your team, and they may advise you to either ride it out for a little longer or suggest a different treatment.

Here is our VA link which suggests you may start to feel better in 2-12 weeks:

https://www.versusarthritis.org/about-arthritis/treatments/drugs/adalimumab/

In the meantime do keep chatting to us and have a good snoop around the community!

Take care,

Sarah

jamieA

https://community.versusarthritis.org/discussion/55810/biological-medication

Hi,

I was diagnosed with psoriatic arthritis in October 2020. I'm also on Amgevita - since the end of July 2021. I'd previously been prescribed sulfasalazine and then methotrexate - both of which I'm still on as well as the Amgevita. The rheumatology clinic said the drugs worked in tandem. Neither the sulfasalazine nor methotrexate seemed to work for me either on their own or collectively but the rheumatology clinic explained I needed to complete at least 3 months of each before they'd make any decisions on other medication. They put me on Amgevita when it was obvious there was no improvement and by week 3 - ie the week after my second injection I could feel a difference. Since then things have improved significantly for me from an arthritis point of view. At my last rheumatology clinic the nurse said I'd been really lucky that the first biologic had worked and if it hadn't they'd have tried another of the 7 (?) biologics available until they got the right one for me.

bikingviking

Thank you for you comment, I have now injected my 6th injection, i.e. 3 months worth and it does not seem to have any good effect on me. My rheumatologist is now suggesting Rinvoq (Upadacitinib) tablets for me but I feel nervous changing mediation all the time and the side effects it will have on me. I am not taking methotrexate any more at all but take Hydrochloroquin tablets along with the bio. I quite new to RA only diagnosed Jan 21. Came on out of the blue!!

Good luck and glad you've found some relief.

TGO

Morning all

new to the site, diagnosed with osteo arthritis knee /hips.Xray confirmed it.

stopped my playing golf after 40 yrs came on suddenly.Want to help myself told not to take iboprofin as have A F - heart condition, taking CO- codimol and Amitriptyline for sleeping that helps .likely operation down line.

Question is what can I use prescription or otherwise to reduce discomfort that may help me return to golf ? Happy to use buggy if needed.

Anna

Hi @TGO and welcome to the online community,

You've been diagnosed with osteoarthritis in the knees and hips and you’d like to find out ways to reduce your discomfort and return to playing golf.

Regarding your medication, it’s always best to discuss this with your GP as what suits one doesn’t always suit another. You may be able to be referred to a pain clinic where they can look at different ways, including physiotherapy, to help you.

Its a great idea to continue with exercise, and after 40 years I would imagine that you must be pretty good at golf! Other members may have some experience of how best to get back to it, but meanwhile have a look at the Versus Arthritis webpage that gives some reader’s tips and suggestions for getting back to exercise:

https://www.versusarthritis.org/about-arthritis/exercising-with-arthritis/

You also might be interested to read a personal story from one of our members, Ash, who is learning how to overcome the physical and emotional challenges of arthritis and is pursuing a professional career in golf.

https://www.versusarthritis.org/news/2021/march/ash-s-journey-from-self-loathing-to-self-acceptance/

Best wishes, Anna ( Mod)

TGO

Many thanks for your comments, understand the need to try and excercise to help build up muscle and support for affected joints , but as we know being able to exercise is in itself challenge arthritis in aff cited area are very painful , but being able to move around even with extreme discomfort is to be encouraged but it’s being able to do simple stuff , walking is very difficult , so golf is complete no no at moment even using pain killers (Co- codimol ) suppose I’m asking is there any other medication other than ibuprofen I can use , as my GP has advised not to use it. Any advice would be helpful , want to avoid surgery at 80 yrs old if possible should it be required thanks all

TerryOwen

Arthuritis

@bikingviking @TGO It does seem rather sudden, and felt that way to me too, when I was diagnosed in Oct 21 with an aggressive form of RA, with ACCP over 500 (norm is under 14) and RF of 115 (now 160) However looking back, there were niggling early warning signs, 9 months before, starting with foot pains & swelling causing me to keep buying new shoes, a behaviour often seen in early RA. I had also had covid before. The current thinking is if you have a genetic predisposition to it, the right sequence of environmental factors can trigger it. eg viral infection, prior gut problems eg IBD, connective tissue/joint excessive irritation & inflammation injury followed by vaccination before inflammation is fully resolved.

My nhs hosp rheumatology team confirmed vaccines are known to trigger flares but if the RA is well managed the flare comes down. However if there is no management as would be prior to disgnosis then something subclinical can become a full chronic disease, which is what they thought happened in my case.

Biologics is something I might have to consider months down the line if the MTX does not fully kick in. It is a shame that so much focus is put on developing expensive pharmaceuticals like biologics that just take a sledgehammer to the immune system saddling us with lifelong dependancy & a whole host of nasty risks & side effects while promising research to address RA specific failure, ie loss of tolerance to self proteins and treatments to restore that tolerance is starved of funds.

The immune system produces T cells that attack or T cells that regulate any attack all the time even in healthy people, but the regulatory T cells & “teacher cells” (Dendritic) keep things in check. When this balance is lost a self sustaining feedback loop is created which is very hard to break without this directed research.

There maybe something in the diet too, worth looking up a Guardian article entitled “Global spread of autoimmune disease blamed on western diet” + James Lee + Francis Crick Institute + Vinuesa

I found certain foods do make my RA worse, so I avoid them, however its very individual specific, best explained by well known doctor & scientist Prof Tim Spector. His lectures on nutrition & disease at University of London & the Royal Institute are on youtube.

I hope you find something that gives you some relief, but its not likely to be a silver bullet, but a combination of things.

jamieA

@Arthuritis

We seem to have taken a similar path - though in my case I've been diagnosed with PsA not RA - I've had psoriasis all my adult life. Like you, looking back there may have been signs - I was treated for plantar fasciitis about a year before things blew up - it was put down to too much walking as I was walking 60-70kms a week. Like you I was told I'd probably had covid - in March 2020 - 6 months before the PsA kicked off. I went from a swollen knee to hospitalisation in the space of 8 weeks - with a CRP level of 340 and pneumonia into the bargain. I had a period of about 8 months when I was barely functional - at times I struggled to get out of a chair, couldn't close my hands or move my shoulder joints and could only walk with the aid of an elbow crutch. I couldn't butter a slice of toast at times.

The rheumatology nurse I deal with has said it's known that PsA can be brought on by a virus and if you look at how covid interacts with your cytokine levels it's maybe not surprising. There have been a couple of medical papers released that have studied covid and PsA including one in Italy of a patient with psoriasis developing PsA after catching covid.

As I said I've been on Amgevita since late July 2021 and I'm now functioning well - though not to my previous levels. I still have issues with my hands, shoulders, knee and foot - but they are manageable. I'm back to walking about 50-60kms per week but on flat surfaces - not the hills. So for me Amgevita seems to be working - though I know everyone is different and so may react differently.