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Re: Switching back to previously used biologics?
tntlamb #275350 07/14/16 11:31 PM
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There are now 5 TNF drugs approved for AS: Humira, Simponi, Enbrel, Remicade, and cimzia. The future of AS treatment is the IL drugs and not TNF drugs. Or perhaps the gut bacteria is where the research will turn depending on a couple of ongoing trials.

Best of luck on the enbrel. I have been off simponi as long as three months and it was still just as effective when I went back on it.

Last edited by drizzit; 07/14/16 11:44 PM.
Re: Switching back to previously used biologics?
tntlamb #275351 07/14/16 11:34 PM
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Originally Posted By: tntlamb
Its important to have confidence in your team. But it is also important for your team to have confidence in the research already done. There are NOT a lot of options for biologics effective for AS, despite the fact there are consistently more biologics becoming available. In fact the move in biologics for AS is towards something entirely different than TNF inhibitors. (interleukins) There are still only 3 anti-tnfs approved. Others may work though.

There is significant research about time of response especially with AS. We don't have a simple "arthritis" that most rheumies are most familiar ad experienced with. (nothing simple about arthritis BTW)

I can't disagree with the concept of lets try to find something effective as quickly as possible and I wish you luck with Enbrel. I still think its the best. I wish that the subsequent meds I have used since Enbrel (after six years)being forced to another med because of uveitis were as good for my axial pain. The good news is what appeared to be inevitable fusion stopped dead in its tracks when started the bios. I can deal with pain in other ways.

I would suggest however you don't give Humira a failing grade. You may well want to return to it someday. Whether it is eye issues or disease progression.


Thanks for the response. I definitely do not give it a failing grade. It helped me significantly. And I feel pretty good today and yesterday, which almost has me feeling like I should stay on it. But I already have a months worth of Embrel, so I guess I'm switching for now. But I certainly will turn back to Humira if the others aren't as good some time in the future.


Early 30's male, HLA Negative, AS diagnosed Feb. 2016, Humira.
Re: Switching back to previously used biologics?
obrienk84 #275352 07/14/16 11:55 PM
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My final question is--do the antibodies only develop when you are on the drug, i.e., once i'm off it, no new antibodies can develop? Or is it somehow possible for the development to occur against the old drug after I've transitioned to a new drug.


Early 30's male, HLA Negative, AS diagnosed Feb. 2016, Humira.
Re: Switching back to previously used biologics?
obrienk84 #275358 07/15/16 01:19 PM
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Don't forget about Cosentyx. It's the new kid on the block. I personally did not have success with it, but I also did not have success with Humira. Simponi worked great for several months, but I had efficacy issues with it-even when upped to every three weeks from monthly. The biggest problem is that we are all different and our body chemistries respond to each of the meds differently.

I get a ton of info from my infusion nurses (just recently started Remicade), and they were pretty forward in telling me that AS is the hardest of the auto immune diseases to get under control. Just my two cents.

Best of luck. It's kind of a "journey" to figure out what works best for you.
K


Kelly
Female diagnosed with AS in 2014.
Keeping an eye on the pipeline of new biologics and therapies.
This one, of all the auto-immune diseases is a real spam - so hard to treat! So, REALLY love to read success stories!!!!!!!
Re: Switching back to previously used biologics?
tntlamb #275359 07/15/16 01:54 PM
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Originally Posted By: tntlamb
In the case of Humira, there is a blood test to check for antibodies (which are rare.) and blood levels of the med. If on the fence at this point, it may be worth having done. In any even 4 months is not an adequate trial for any biologic especially if you are experiencing any relief which typically doesn't start until month three anyway. Of course some folks get relief quickly, but by the same token others (in similar numbers take longer.) I have not heard of SSZ reducing the effect of the anti-drug antibodies but yes MTXis frequently used for that purpose and has been included in most trials

Thanks for Sharing tntlamb
Can someone please let me know what test would that be to check for antibodies ? I would like to bring it up with my rheumy on next appointment.

Thanks in advance!


Male, early 30s. AS diagnosed Sep 2015. HLAB27+
Current medicines: Omeprazole, Vit D3, Celecoxib(1 tab)/Zorvolex(2 tabs)(alternatimg between these two every week), Pyridoxine, Isoniazid, MTX(3 tab) every wednesday, on humira every two weeks since Dec 2015, Weekly Humira since June 18th 2016
On cosentyx 300mg a month since Dec '16
Re: Switching back to previously used biologics?
obrienk84 #275360 07/15/16 03:20 PM
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The test for Humira is described here:

http://www.mayomedicallaboratories.com/test-catalog/Overview/58031


There is some pretty exciting stuff going on in the whole immunology area regarding these meds. Quietly there is a test being done that can predict which biological is most likely to be effective. While the primary work is being done with RA all of the ugly step children such as AS will benefit. I have talked to folks who believe it will be widely available and in general use with in the next 24 mos.

Here is a VERY general article: http://www.news-medical.net/news/2015070...A-patients.aspx

This is another version being used in Japan: http://www.kayteebio-english.com/biologicmate/

The US version is likely to come from this research (there is already a version being used for Cancer treatment):

https://genomemedicine.biomedcentral.com/articles/10.1186/gm463

The important thing to keep in mind is non response to biologics or having them suddenly "quit" is increasingly being thought to NOT be the formation of antibodies but something else. It makes sense because frankly with the exception of Remicade most bilogics are either actual Human DNA or synthetic Human DNA. If we were to routinely develop antibodies to Human DNA, we would be in a world of hurt.

To me though the most exciting part of the research is the fact as we learn more about the "binding effect" of the biologics we come ever closer to an actual cause of the disease and at some point someone will correctly refer to Biologic therapy as "crude" and the "old days" Hopefully we will see it in our lifetime.

Re: Switching back to previously used biologics?
obrienk84 #275361 07/15/16 05:50 PM
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trust me that is what I live for, to see an end to AS. I know it is an unknown enemy, so waiting for the time when it reveals itself, and we are able to kill it for sure.


Male, early 30s. AS diagnosed Sep 2015. HLAB27+
Current medicines: Omeprazole, Vit D3, Celecoxib(1 tab)/Zorvolex(2 tabs)(alternatimg between these two every week), Pyridoxine, Isoniazid, MTX(3 tab) every wednesday, on humira every two weeks since Dec 2015, Weekly Humira since June 18th 2016
On cosentyx 300mg a month since Dec '16
Re: Switching back to previously used biologics?
tntlamb #275782 08/25/16 08:29 PM
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Originally Posted By: tntlamb
The test for Humira is described here:

http://www.mayomedicallaboratories.com/test-catalog/Overview/58031


There is some pretty exciting stuff going on in the whole immunology area regarding these meds. Quietly there is a test being done that can predict which biological is most likely to be effective. While the primary work is being done with RA all of the ugly step children such as AS will benefit. I have talked to folks who believe it will be widely available and in general use with in the next 24 mos.

Here is a VERY general article: http://www.news-medical.net/news/2015070...A-patients.aspx

This is another version being used in Japan: http://www.kayteebio-english.com/biologicmate/

The US version is likely to come from this research (there is already a version being used for Cancer treatment):

https://genomemedicine.biomedcentral.com/articles/10.1186/gm463

The important thing to keep in mind is non response to biologics or having them suddenly "quit" is increasingly being thought to NOT be the formation of antibodies but something else. It makes sense because frankly with the exception of Remicade most bilogics are either actual Human DNA or synthetic Human DNA. If we were to routinely develop antibodies to Human DNA, we would be in a world of hurt.

To me though the most exciting part of the research is the fact as we learn more about the "binding effect" of the biologics we come ever closer to an actual cause of the disease and at some point someone will correctly refer to Biologic therapy as "crude" and the "old days" Hopefully we will see it in our lifetime.


Hi TnTLamb,

Thanks for sharing. How does this work? I am on humira currently(weekly).
I wonder if humira is even working on me any longer. How would my rheumy know what biologic would work on me? Is this still in research stage?

Thanks,kindly.
ShippingNews


Male, early 30s. AS diagnosed Sep 2015. HLAB27+
Current medicines: Omeprazole, Vit D3, Celecoxib(1 tab)/Zorvolex(2 tabs)(alternatimg between these two every week), Pyridoxine, Isoniazid, MTX(3 tab) every wednesday, on humira every two weeks since Dec 2015, Weekly Humira since June 18th 2016
On cosentyx 300mg a month since Dec '16
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