Rheumatoid arthritis and biologics

[plymouthmaid]

Hi! I was diagnosed with rheumatoid arthritis 8 months ago. After trying methotrexate and leflunomide, my consultant has suggested that I move on to a biologic. She has given me a choice between Etanercept and Adalimumab. Does anyone have any opinion on which would be the one to go for? Thanks!

I’m on Adalimumab (for psoriasis and psoriatic arthritis) and it has been very good for 5/6 years but has started not being so effective this year.

It’s easy to administer yourself by jab at home.

The one disadvantage is it causes immune suppression (all biologics do) so you need to be careful on that front around certain foods and other people’s viruses. I get an annual Covid jab. You’ll need pneumonia and Shingrix jabs before you start, and annual flu jabs (from memory).

It’s effective though.

Can’t comment on the biologics, but saying hi! Similar timeline but tolerating MTX well. What’s your issue with it?

Good luck btw

That’s helpful. Thanks!

I think I was the poster girl for methotrexate side effects! It made me feel absolutely horrendous.

I’m surprised your rheumatologist is giving you a choice. They’re meant to be the experts after all! Although I suppose if there are differences in delivery mechanism or frequency, there may be a lifestyle choice as which one suits best if they are both equally effective.

I was on humira (the original Adalimumab) for psoriatic arthritis. I started every 2 weeks but moved to weekly as it wasn’t doing much. It definitely helped but wore off 2-3 days before the next dose. She moved me to Taltz which is every 4 weeks but I still have the same problem of it wearing off.

While biologics are also immunosuppressants, they are much more targeted so less impact on your immune system generally. Traditional DMARDS like methotrexate are basically a sledgehammer whereas biologics only target specific inflammatory pathways.

I was on it for a month to try and deal with the drop in effectiveness of my biologic towards the end of the 4 weeks. It was the most awful experience of my life. I had 5-6 days of feeling absolutely horrendous and 1-2 days of only feeling awful. Leflunomide was almost as bad. I only lasted a week on that.