Can anti TNFs and their effectiveness 'burn out' ?

I read somewhere that studies show some anti TNFs are not as effective after a year but I've only been on humira for 8 months. I'm not having a flare up, as such, just a slow return of symptoms. This happened to me on MTX and then on leflunomide.

I'm slightly loathe to continue in this merry go round of trying every drug on the market if this is going to be a repeat pattern for me. Has anyone else experienced a sudden rush of symptom relief on RA meds and then a slow roaring fire of the disease returning?

10 Replies

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  • From what I have heard on other forums, yes they can lose their effectiveness, but there isn't an expected time frame for this -for some folk one particular one may never really work, for someone else they may get good results for six months or a year or more, and others are lucky enough to find one that works for years and years. Its very individual, and right now there is no way of testing who will respond and who won't. The good news is that even if you "fail" one antitnf, the chances of you getting a good response from a different one are actually fairly good. If you think yours isn't as effective as it was or isn't effective enough, then definitely talk to your rheumatologist about the possibility of switching.

  • Hello

    You may find after a period of time that it may become less effective. All medications need to be checked regular and some people my need changes sooner or later in fact all of us are different and medication effect everyone differently that is why we need regular blood tests etc

    BOB

  • Hi,

    I have found that medicines effect has worn off after a while - either that or the disease goes up a gear. I was on Gold for around 7 years and then Enbrel for around 7 before both of them began to lose their efficiency. It is very difficult when something that gives you a life line stops working but I know that without anything I cannot manage. Different biologics have different modes of action (work on different cells) so it is worth trying another one. Do keep in contact with your rheumy nurse if you feel things are getting progressively worse. Farm

  • I was on Humira for 2 years before getting psoriasis, I have never had bad skin in my life and I'm 61. I was told it was Humira and am no longer on it but otherwise it was brilliant! I haven't been put on anything extra in it's place as yet. Like you I have had a reaction to just about every drug I've tried. Very frustrating.

  • I've had this problem all the way through my disease history of 21 years so can sympathise. I wouldn't let your symptoms get too bad before you talk to rheumy. I've been on 3 anti tnfs and now on Rituximab. The last infusion on May/June didn't work at all so I had a depo and booked in for more. They said it may be a one off but I've been on it 7 years ( the longest I've been on any drug) I think it's just run it's course. I may end up on Toxizulimab instead. We are lucky there are lots of drugs.

  • I think it's a recognized problem with all drugs. I've worked my way through all the DMARDs, then Enbrel, now I'm on Rituxi. Luckily there are many drugs out there now, and they can now target the disease rather then just mask symptoms. Time to talk to the rheumatology team perhaps?

  • Thank you for the replies, although I am sorry to hear that other people are experiencing the same. I asked last night because I had a rheum nurse appt at 9 this morning. My DAS has gone up from 1 point something to 4.1 which I had suspected. :( I am picking up lots of viruses, colds and stomach bugs, so the decision is not to increase any of my current meds but to wait until my rheum appt in March and re-visit. I feel happy with this. Well, not 'happy' but I think it's the best course of action.

  • Hello Crashdoll, I never thought that I would be saying this about my Bio's. I am on Adatacept, which as far as I know is the last Bio drug available to me, I can't take MTX.

    When I first used Abatacept it was, for me, a wonder drug. I had almost no pain at all for over a year then in the late spring of this year I had a bad flare and the first one for a very long time. From that time the effectivness of the drug has gradually decreased to the point that the disease has now started to spread again.

    I hate complaining as from the time I was first put on Bio's, even though some of them didn't work, I have never went back to the really awful times when I literally could not move and had 0 quality of life.

    I'm seeing my Rheumy Consultant in January but I think like me he will be very disappointed at this turn of events. As I said earlier Abatacept is the last drug available to me but i live in hope and I have great, great faith in all of my Rheumy team to do the best they can for me.

    So in answer to your question unfortunatly I have to say yes, I find that Bio's doloos their effectivness in time. No one knows how much I hate to say that.

    All the best.

  • Hello Crashdoll, I never thought that I would be saying this about my Bio's. I am on Adatacept, which as far as I know is the last Bio drug available to me, I can't take MTX.

    When I first used Abatacept it was, for me, a wonder drug. I had almost no pain at all for over a year then in the late spring of this year I had a bad flare and the first one for a very long time. From that time the effectivness of the drug has gradually decreased to the point that the disease has now started to spread again.

    I hate complaining as from the time I was first put on Bio's, even though some of them didn't work, I have never went back to the really awful times when I literally could not move and had 0 quality of life.

    I'm seeing my Rheumy Consultant in January but I think like me he will be very disappointed at this turn of events. As I said earlier Abatacept is the last drug available to me but i live in hope and I have great, great faith in all of my Rheumy team to do the best they can for me.

    So in answer to your question unfortunatly I have to say yes, I find that Bio's doloos their effectivness in time. No one knows how much I hate to say that.

    All the best.

  • Great advice given and I feel exactly what Farm said ... the disease goes up a gear. My rheumy used to say when I was on MTX alone (had been for 8 very good years too!) that it was no longer working well enough and they needed to go in with a blunderbuss rather than try tinker around! Well that gave me worries about biologics (think the majority of people have but once you realise so many people are on them and have success stories you feel more confident .. and the alternative of RA out of control is miserable) but think they give less side effects in so far as you don't feel ill taking them, but fully understand people have allergic reactions etc (but I am very allergic to the humble aspirin!) I think there is such more choice and plan B C D etc in line for people who fail a med, and we can only hope that the med we decide on is the one that is going to turn things round.

    I thought nothing would get me out of the daily electric RA shocks .. RA out of control and flaring, but Rituximab working very well so far. Early days. There is no guarantee which med will work but we have to keep going till we find one that works. I know there are some people who do not respond (can't recall the exact terminology for this .. Jeanabelle can you advise? ) but hopefully most of us do get to respond .. and do well. I had a fairly useless 2013 with two anti-TNF's failing before Rituximab but have had success long term with Sulphasalazine (for 8 years) then with MTX in earlier times of RA. I consider those two successes for that period of time as 8 years a piece approximately is good going. Fortunately there are much more advanced meds to take but unfortunately I took my time to build up courage to take biologics. I don't often say my advice .. but my advice is not to linger and worry, and to go for a biologic if offered.

    To Jeanabelle ... yes I think biologics in general seem to lose their efficacy sooner but then I see exceptions to that rule where people have been going on one successfully for ages. I am so sad to hear you have tried so very many and not had a good response. I hope that you may be eligible for any new meds coming in and that something done it for you soon. I think you have a great outlook and please keep your positivity. ;-) x

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