Do all biologics need DMARDS with them to work effec... - NRAS

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Do all biologics need DMARDS with them to work effectively.

17 Replies

My rheum. team might be thinking about changing my biologic and I want to be as prepared as I can be before I go and meet with them. At one point, in this forum, before I registered and simply read posts, I was sure someone mentioned a biologic that works on its own. Does anyone know which drug it was and has anybody used it?

Sal

17 Replies
cathie profile image
cathie

Ah I know something about this. I was seen in gastroenterology recently because the methotrexate was damaging my liver. Or thats what my bloods suggested. And I asked them this. They use biologics too - maybe for Crohns - I dont really know, ANyway they said that they commonly give biologics for people who can't take methotrexate. Perhaps that applies to other DMARDS?

There was also an article in the last NRAS magazine about a specific biologic which doesn't need anything else to work. In the right people of course!

I was under the impression that most biologics are tested in trials with MTX, as it generally gives better results and also, MTX stops you creating antibodies to the anti TNF.

helixhelix profile image
helixhelix

The guidance from NICE - which is the body that basically says what the NHS can and can't prescribe for you - does say that Adalimumab (aka Humira) and etanercept (aka Enbrel) can be used without MTX.

Here's a link to the pathway guidance which sets out the order things should be tried in.. pathways.nice.org.uk/pathwa...

Hi Sal

I'm on biologic treatment and I don't take any form of DMards, im taking Simponi {golimumab) and I have been on that 2 yrs. now and i'm in remission, although im still in pain due to the long term damage on my joints. But ive had a couple of other biologic treatment without dmards,

Wildschonau profile image
Wildschonau

I take enbrel without methotrexate. I started in October and I am now in remission without any pain or stiffness - it is my wonder drug.

wiliby profile image
wiliby

I take enbrel without a dmard also, did start with mxt but stopped a year ago and thankfully still works miracles :)

My consultant did say I was at risk of enbrel becoming less effective, good luck :)

Bazzypants profile image
Bazzypants

Hi there, I am also taking Humira with out anything else I do have pain killers and have been having steroid injections to. good luck. xxx

Dogrose profile image
Dogrose

I didn't take anything with Humira but now I'm on Infliximab and I've been told I can't take it without taking MTX even though it makes me feel bad. xx

francherry profile image
francherry

Hi Sal, I was on Humira without MTX and now Enbrel (also without MTX). It's too early to say if the Enbrel is working but hope I'll start to see a difference soon. Fran

benjijen profile image
benjijen

I was on methotrexate and couldn't stay on it due to reactions. I was put on Humira but told I had to stay on Salazopyrin as well. My GP thinks this is why I can't get control over my blood pressure even though I'm on various meds for that. I'm also on thyroid meds.

Hi there, I was on Humira for 3 years without methotrexate and was fine (although currently off all meds to try for a baby which is a struggle) x

BoneyC profile image
BoneyC

I took Humira without MTX then after that failed, had Rituximab infusion again, without MTX. I had been on MTX for over 30 years but became neutropenic which I was told was probably caused by the MTX and I should never take it again. When I had the Rituximab infusion the same Rheumatologist changed his mind and said I had to take a low dose 2.5mg MTX. I reminded him what he told me 2 years before and that NICE say although its preferable to take MTX with Humira or Rituximab, not if the patient is intolerant to it. Rituximab didn't work either and still not taking MTX.

Judetheobscure profile image
Judetheobscure

Hello, I've been on enbrel for a few years without MTX. It has worked very well indeed. Trials showed it to be most effective when taken in conjunction with MTX, and NICE regs say enbrel should be given alongside MTX unless the patient is intolerant to it. The two together brought my immunity levels really low so I was allowed to drop MTX. I have read papers suggesting that with enbrel you should be safe re allergy/antibodies to the anti TNF.

NRAS will probably be able to advise further on that.

Jeanabelle60 profile image
Jeanabelle60

hello, i have been on bio's now for about 18 months. i was put on them because MTX was attacking my liver. i had to try three previous bio's before i was given on that works for me: Abatacept. my self injection is the only medication I'm on now for Rheumatoid Disease. it is a wonderful drug and has given me my life back again. hope this helps.

Ozzy profile image
Ozzy

I was on Humira without mtx, it worked well for over a year than I caught a bug and the drug stopped working so well. If I had taken mtx with it I may have not developed antibodies against it so I could still have been enjoying the benefits. I am at present waiting for funding for tocilizumab which does not have to have mtx with it if you cannot take mtx, unlike most of the other drugs available which I think that you have to take mtx to get the necessary funding, as the drugs do seem to work more effectively with mtx.

Loura profile image
Loura

I have autoimmune hepatitis as well as RA. I am prescribed mercaptopurine for my hepatitis and will soon be starting biologics. You are right in staying that gastro also use dmards for conditions such as chron's and ulcerative colitis which I also have. Such fun!!

Anyhow. No two people are the same, and can react to drugs in different ways. I was allergic to methotrexate and various others. Am hoping biologics will improve my RA. Have a lovely day and enjoy the sunshine everyone.

sjhewitt42 profile image
sjhewitt42

Hi I can’t tolerate DMARDs so have had success with Cimzia without anything else. Unfortunately it stopped working after 5 years but it gave me my life back on its own. xx Sarah

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