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Enbrel with Other Therapies
Ok, here is the
deal. I have been on Enbrel for over three months. I started out with two
injections per week, then with no signs of improvement we bumped that up
to four injections per week. So here is the good news, my P has changed,
it is now flat and doesn’t flake (still red like a fire engine though).
still continue to get more spots and they are spreading at an alarming
rate. With the use of creams and of course my own light bed I have been
working my hardest to keep them at bay.
So here is my
question. Have you ever heard of taking Enbrel with other oral medication
(like MXT)? I mentioned this to my derm and she said it has been done
before. Unfortunately, she is not monitoring my Enbrel, due to location
problems. My Family doc is administering the Enbrel, and I know that
unless I can come to him with an in-depth plan he will not allow me to
combine other meds with this one. Any suggestions would be great.
Response: Hi Crystal.
I've heard of combining Enbrel with other regimens; however, if
Enbrel isn't controlling the spread of your P, I wonder about the utility
of combining it with MTX. The
promise of biologics like Enbrel is their ability to replace other
systemics considered dangerous in the long run.
MTX and cyclosporine are those "dangerous other
systemics." Most of the
combo regimens I've heard about double Enbrel with some non-systemic
treatment, usually light therapies (like you're already using) and/or
topicals (corticosteroids, Dovonex, Tazorac, etc.).
I've only heard about use of the systemics with Enbrel in an
"overlapping" program. For
example, a gradual phase-out of MTX or cyclo after Enbrel has commenced.
MTX (and cyclo)
are powerful immunosuppressive drugs.
Enbrel and the other biologics currently approved for P treatment
are also immunosuppressives. But
there’s a big difference. MTX
messes with a wide array of immune system functions — many of which
probably don’t have anything to do with P.
The new biologics, on the other hand, target very specific
functions inside the immune system and are supposed to leave everything
else alone. Taking an
effective dose of MTX might supercede anything the Enbrel is doing.
Having said that, I just burrowed into the “prescribing
and found a reference that states Enbrel and MTX were used simultaneously
by some rheumatoid arthritis patients and the “pharmacokinetics of
Enbrel” was “unaltered.”
By the time you
read this you've probably been on Enbrel for over four months (more)?
I was on 2 shots a week for 3 months and 4 shots a week for 3 more
months. I gave the drug a
total of 6 months before abandoning it.
At the end of six months there was no indication of ANY SORT that
Enbrel would work for me. My P
lesions were angry as ever and continuing to grow.
(Evidently they'd not been made aware that Enbrel was supposed to
Now it’s been
almost seven months since I stopped taking Enbrel.
For six months after that I took cyclosporine, which, as usual,
cleared my skin and nails. Now
I’ve been off everything for three weeks and the lesions are trumpeting
their return. Most alarming,
however, has been the swift return of the psoriatic arthritis in my right
knee. It snuck up on me
virtually over night. I went
to bed with a normal knee, woke up the next day with jr. basketball-sized
knee that was hot to the touch. Cyclo
doesn’t do much for PA except keep it in abeyance after something else
has managed to suppress it, so it has to have been the Enbrel that
thwarted my PA last year.
Good luck. Please let us know what you decide to do and how things turn out. -Ed