Thoughts on Adalimumab?

SJand

Hi all,

New here and hoping for some advice from fellow RA’ers!

I’m mid 30s and was diagnosed a few years ago, have been on methotrexate tablets (made me ill), went on to Metaject and (not able to tolerate more than 15ml), and take hydrocloxi - still don’t know how to spell or say it! - every other day. My next option is to try Adalimumab. I’ve been told I’d start off using this with the metaject then taper it off until I’d eventually just be on the biweekly biologic. I would love to get my meds down to a minimum (still hate injecting!) and inflammation in hands and feet down for pain management and before any long term damage is done. I’m currently largely dealing with tendon and soft tissue pain with some nodules I’ve been told would be removed once I find a suitable, stable med.

Apologies for the length and background, but it’s just so much to think about when looking at the potential lists of side effects! One consultant told me it’s great, and another that it’s a huge concern for infections and increased risk of skin cancer. I appreciate everyone is different, and I’m not asking for medical advice per se, but keen to know how others have got on with the switch from DMARDs to biologics?

Had an appointment this week and asked to have a month to think about it all before deciding.

Thanks in advance for any views! X

chrisb

Hi @SJand,

Welcome to the versus arthritis forum.

You've some to the right place to ask for input to help with your decision.

Whilst you await some feedback, you may find these articles relevant:

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

This past discussion may be informative:

https://community.versusarthritis.org/discussion/63351/adalimumab

If you use the forum's search facility you'll find lots of previous discussions as regards this drug.

Best wishes

ChrisB (moderator)

Arciere

Hello @SJand

I did not suit DMARDs. They made little impact to my hand and feet pain and actually affected my mental state I think. I was incredibly emotional and out of character while taking DMARDs.

The two I had were Methotrexate and Sulfasalazine. I came off both as a hard stop and I don’t recommend that. Essentially I was being prescribed DMARDs via private prescription and then the insurance ceased covering me as my condition was now chronic. I then faced a delay between leaving private and seeing an nhs specialist. The crazy part was that my GP couldn’t prescribe what the private specialist had!!!! Anyway - I was helped along with oral steroids until I got to see the nhs specialist. So please do agree a good taper.

The good news is that I really rate the Adalimumab. I haven’t felt any side effects and along with dietary changes (see my other posts) I am pretty much living like I don’t have RA. Although I’m still stiff after being sedentary and I do have hand pain - but nothing like before I started taking it.

My view therefore is that the benefits out weigh the risks you can find online. I’ve only been taking it for 9 months.

Hope this helps

jamieA

Hi @SJand

I have psoriatic arthritis which was diagnosed in 2020 when I was 65 so I don't know how relevant you will find my response.

I've been on the adalimumab biosimilar Amgevita since July 2021 and it has certainly worked for me. I started off on sulfasalazine which didn't work, then methotrexate was added and the combination didn't work. Amgevita was added and two months later I was able to hand back the crutches I'd used for almost a year. I now walk my dog 50-60kms a week. My rheumatologist describes the 3 drug treatment as synergistic or simply 1+1+1>3.

I've had no side effects that I know of from the biologic. I am aware I'm immunocompromised and just try to ensure I take any precautions I can. I'm registered for free covid tests and antivirals in the event I get covid. I'm aware I shouldn't eat unpasteurised foods, undercooked meat and fish and pate. I steer clear of any family who are unwell with infectious/contagious illnesses and generally stay clear of crowded areas if I can - though we look after our 18 month old grandson two days a week who's a walking petri dish! I'm aware that I shouldn't get too much sun - though living in the west of Scotland that's unlikely anyway. I carry methotrexate and adalimumab patient cards in the event I'm hospitalised.

I hope it works for you.

SJand

Thank you, @Arciere and @jamieA!

That’s reassuring. I’m sure you’ve both been in the same position where you’re not quite sure which route to take, and not knowing anyone (personally) in the same boat.

I do think that I’ll try it, but my last appointment with a different consultant cast some doubt after talking about the high risk of various infections - Chest, urinary, skin, stomach, eyes…! I know they have to tell you about possible risks, but the pitch made it sound like I’d be like the walking wounded! Then again, I suppose if you read the warnings on paracetamol it makes it sound as if you could drop dead!

Grateful for your views and personal insights!

jamieA

Hi @SJand

I'd likely had covid in 2020 (before my PsA diagnosis) and that appeared to trigger a number of health issues. My rheumatology department is in a hospital that doesn't have an A&E or admissions ward. After my PsA diagnosis but before I was put on MTX or Amgevita I was admitted to the main A&E hospital 5 times with recurring pneumonia and then a heart complaint. That meant I saw a whole host of different rheumatologists during my hospital stays - probably around 10 - that weren't my consultant. It was surprising the number of different views I was given on both what was wrong with me (PsA, OA, AS, Gout, Pseudogout, Polymyalgia Rheumatica) and the possible treatments. I'm an engineer by training so it was a real eye opener that there could be so many differing views among medical professionals.

Arciere

hi @SJand

yes, I remember going through the tick list of possible outcomes thinking that I’ll be really sick all the time. However - touch wood - I haven’t been ill at all - quite the opposite in fact.

Good luck

JanP_72

Hi, I’m new to the boards. I’ve had fibromyalgia for 20+ years and diagnosed rheumatoid arthritis 14 years ago. I’ve had all the different concoctions going. I’ve been taking Hydroxychloroquin tablets, Methotrexate injections weekly and Imrald injections every 2 weeks for over 4 years. I also have co-codamol and amytriptiline as pain relief. On the whole this all works for me. I have flares, usually as the colder wet weather set in (now) but can usually manage to get through. Yes, adalimumab etc can suppress immunity, and I got Covid 3 times, even though I’m careful…obviously not careful enough! . Needed antivirals once, but the plus side of the medication means I’m still able to get out, walk, swim, dance(😂😂), which is absolutely 100% better than before the meds, I was looking at the price of wheelchairs!

MaryL44

Hello @JanP_72 and welcome to the Community. We are a friendly and supportive group and I hope that will be your experience as well.

Our website is a mine of information so do look at it while you're here.

Also, our community members will have vast experience so keep checking back here for their responses.

Please keep posting now you are here and let us know how you are getting on.

Best wishes

Mary