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Biologic Question - any help appreciated
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jadedamber posted:
have had psoriasis (75% coverage) and PsA since the age of 15 (17yrs now). I have used many treatments, everything from steroids, topical steroids, light therapy, laser therapy, oral medications(accutane), and biologics, I first used Enbrel for 5 years, Remicade for almost 6, lastly Humira for 4 months. Out of all of these the Remicade was the most effective with the least amount of side effects for the most of the 6 years. The only reason I stopped was the efficacy of the Remicade started to go downhill. I was only getting 4 weeks of relief with infusions every 6 weeks. We tried changing the dose and dosing schedule, but when we did that I started having more side effects from the drug. I had increased itching and almost a lupus like effect from the increased dose so after talks with my Rhuem and GI doc we decided to switch to Humira.
Things started to get really bad toward the end of Remicade and the start of Humira. I ended up in the ER 6 times with 2 hospital stays. I had a wide array of symptoms; I was sweating buckets but cold, more tired than normal (I would fall asleep eating sometimes), I was also very emotional/teary, my blood pressure was all over the charts very high(210/120) or very low(70/40) I have never had problems with my blood pressure before, I was unable to get comfortable no matter what i tired, my skin would get flushed/red, I was constantly nauseous with bouts of vomiting and most times unable to eat or even drink. Also when I had these episodes I would end up with red inflamed joints at the end of the day, I was having a lupus like reaction with the Humira as well. I would try to put up with this as long as I could but I would eventually end up in the hospital dehydrated. I have been through almost every test in the book and have no answers. I have also seen many specialists. All of my inside structures/organs appear normal so the doctors are having a hard time coming up with a reason.
I started slowly been cutting medicines out of my life to see if maybe one of them was the culprit, the only ones I didnt stop were my pain management meds and the Humira. After the most recent stay at the hospital I took a chance and stopped the Humira and havent had any episodes since then.
The list of biologics for psoriasis/PsA is a pretty short list and I have tried most of them. I feel like my only options right now are to go back to the dose of Remicade that didnt have adverse effects, go without until something new comes out, or try Stelara. Stelara seems like the best fit for me out of the ones to try that help both diseases, plus it is not a TNF inhibitor so it might cut back on the side effects/symptoms I was having daily.
I was wondering if anyone has similar effects with the TNF inhibitors(Enbrel, Remicade, Humira) if so was there something else you tried with success? Was there a compliment medicine that helped cut back on the side effects like methotrexate or a course of prendisone.
I was also wondering if anyone had any experience with Stelara, If so, were there any side effects or uncomfortable effects?
Sorry this is so long, I feel like the background info is important as someone might be able to relate. I feel like I am at a loss for what to do next, so any help is greatly appreciated
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jadedamber responded:
Has anyone else had these types of problems with these medications?
 
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MrsOC responded:
I don't know if this will help that much, but my doctor is claiming that Remicade is what made me become ANA positive or in other words giving me Lupus like symptoms. Therefore, they will not give me ANY TNF inhibitors anymore. I have RA, was switched to Orencia, then removed from that when it was discovered that I had a MRSA infection. Right now they will only treat me with Methotrexate that I inject. Maybe they could check to see if your ANA is positive before they start you back on the Remicade, if it is, then maybe that is why you are having the lupus like symptoms, like I was having. Just a thought. Hope it helps.
 
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Scott Zashin, MD responded:
My knowledge of Stelara is that it is approved to help psoriasis but not arthritis.


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