Etanercept v Baricitinib?: Next step for me following... - NRAS

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Etanercept v Baricitinib?

Beelady profile image
16 Replies

Next step for me following unsuccessful ĎMARDS or intolerance is one of the above as my RA has been out of control since diagnosis in early 2017. Never thought i'd be 18months down the road, retired on ill health grounds and still trying to find something that helps!

I've asked cons to give me few weeks to read up on both to decide which one I try so trying to weigh up which I would feel more comfortable with and then will have meeting with Rheum nurse to discuss any queries/concerns before starting.

Main issue for me is three years ago I had a small and early skin type cancer /squamous cell carcinoma so am trying to find out risks. I know that with Etanercept (Benepali) there is thought to be a very small SCC risk but cant find much on Bariticinib. I am wondering whether its because its still relatively new? I just wondered if anyone else has looked into this aspect or got any info? Thanks in advance

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Beelady profile image
Beelady
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16 Replies
Shalf profile image
Shalf

Hi Beelady,

Can't sleep so having a browse. I was on Entercept Benepali for approx 6 months. It was the pen injections. I didn't get much relief from this drug, I am currently taking tablet form Baracitinib. Almost 6 months and clearly this is the better one for me. That could be of course, very different for you. If you have the choice then maybe consider how you would prefer to take your medicine. I.E - inject or tablet. I didn't feel very well with the Entercept but that was likely due to the uncontrolled inflammation rather than a side effect of the drug. I haven't experienced any problematic or unusual side effects of Baracitinib. I don't sleep very well, rheumy said that's a classic symptom of Fibromyalgia rather than RA which I also have. Hope this helps. X

Downtime profile image
Downtime

Hi Beelady,

I’ve suffered from skin cancers for years. Mostly basal cell but also a couple of squamous cell. Ive had more than ten cut out and loads treated in other ways. I used to use a sun bed years ago and this is the result!

I have been on Mxt for the last 4 years and the dermatologist said that it increased the chances of skin cancers. I’m now on Humira as well which has changed my life....I feel almost normal.

Anyway the skin cancer thing was my main concern before deciding on a biologic and the hospital were great. My Rheumy dept made all kinds of enquiries looking into studies done, speaking to dermatologists and in the end said that they were pretty much all the same in that respect as anything that reduces the immune system in some way can mean the skins natural protection against sun etc is reduced.

I talked to the dermatologist myself and he recommended taking 2 tabs of nicotinamide daily. This is a B vitamin and an Australian trial was done concluding that it help a lot with prevention of skin cancers there. I’ve been doing this for 6 months or so.

Hope my experience helps a bit in your decision but I spose we just have to weigh up the benefits against side effects as usual x

Beelady profile image
Beelady in reply toDowntime

Thank you for takjng the time. Thats really helpful to know.

Hi. My OH has Baricitinib. Consult. was going to prescribe a biologic ,but when she heard he was having other investigations of Dmard side effects (not skin related) that had a 'looks fine, optimistic its OK, check in 3 months', she put him on Baricitinib. Says he can change to a biologic in the future if req. when all checks are clear. Make of that what you will. Has your Consultant said whether he thinks one is safer than the other in the circumstances? One month in, his stubbornly swollen ankle is better than its been for 10 months. Fatigue as ever, but still on high dose Mtx with a view to dropping it completely soon.

wishbone profile image
wishbone

I used to take etanercept enbrel but was advised to stop because of infection issues. It was great for the few months I was on it and put me in remission. Recently started baricitinib and while not as effective as enbrel was, it is working ok. That said, I am on a low dose of baricitinib because I'm at risk of getting a serious infection. The good thing about it is that it's extremely quick leaving the body, within a couple of days apparently, which is obviously a good thing if I, or anyone, should get an infection.

Dear Beelady, I think you may find the Medicines in rheumatoid arthritis booklet helpful to explain the difference in these two medicines. We can send you one free of charge if you'd like to call us on 0845 458 3969 or email enquiries@nras.org.uk to give us your address we'll post it out asap. In the meantime here is a very short summary etanercept is a biologic medicine meaning it is a complex large-molecule medication derived from proteins which must be taken sub-cutaneously (under the skin). Baricitinb is a 'jak inhibitor' which is a small -molecule, targeted synthetic disease modifying drug which can be taken orally (tablet form).

Hope this helps you make a decision of which to go for. Also if you wanted to talk to somemone who has been on both or either of these medications we have trained telephone support volunteers who we can arrange to call you. Just call our helpline on 0800 298 7650 to arrange.

Clare

Beelady profile image
Beelady in reply to

Thanks Clare. I have looked on your website and think i already have the booklet. I guess ots the info on cancer risk that im interested in. Right now im leaning towards Enbrel as its been going much longer so clearer evidence on the risks i think.

juneann profile image
juneann

I was on Etanercept for maybe three or four years, perhaps longer. Eventually as with many meds and as the condition progresses I had to stop it and move onto infusions with one of the big boys. Etanercept was brilliant and so easy to inject, particularly into the tummy and pain free. Is your condition severe as mine is?

Beelady profile image
Beelady in reply tojuneann

Ah thats good to know. Thank You. Cons had my DAS score at 6.4 yesterday and so said its severe. Its not been controlled since it started in Jan 2017 and ive had to leave work. I feel a bit strange describing it as 'severe' as I look fine and dont have hugely swollen joints like some. I am also seronegative. I have subtely swollen joints really, quite a few of them though in hands, wrists, shoulders and feet and lots of pain and fatigue.

medieval-ali profile image
medieval-ali

Hi

I've been on baracitanib now since May, i must say it works! I do get a muzzly head and a couple of weeks ago it was effecting my eye sight, so i stopped taking it for 2 wks, I've started it again now due to joints flaring quickly, but I've stopped taking the Dmard (leflunomid) along side, at the moment I've no side effects, I'm hoping this lasts as if it effects the eyes again i have to stop.

I've tried humira couldn't get on with it, especially the injections. I'm much better with a tablet. This one isn't an immune suppressant to so I'm in favour of this.

I'm always very apprehensive of new drugs and i put taking this drug for a while, I'm so glad I've given it a chance.

Good luck

Alison

Beelady profile image
Beelady in reply tomedieval-ali

Thanks for your input

Gigi71 profile image
Gigi71

Hi Beelady. I have been on Humira, similar to Entanercept for 10 years. I have Erosive seronegative RD, its been a wonder drug for me. I was on Azathioprine a Dmard alongside it. 2 years ago it was advised I came off Azathioprine and also a risk Humira. This was due to having 2 bcc and scc removed. I was offered Rituxamab infusions but on balance decided to stay with Humira as it worked for me. I did change to mtx. from Azathioprine I haven't had anymore since. I am closely monitored by Dermatology. We are all different, but hope this helps, unable to advise on Baracitanib. All the best. X

Beelady profile image
Beelady in reply toGigi71

Thank you. Really helpful

Mmrr profile image
Mmrr

Beelady , I can't offer anything to help, but just to say I was diagnosed early 2017 and am still uncontrolled too. I'm not coping very well with MTX , my 4th DMARD and expect to be taken off it at my next rheumatology appointment end November. Where you offered biologics or did you request them ?

Beelady profile image
Beelady in reply toMmrr

I didnt get on at all well with Mtx as made me so ill both tablets and injections. Im on hydroxy which helped but only a tiny bit. I had reaction to Sulf and lastly was on Leflunomide but it devastated my white blood cells/ neutrophils so no more left to try. So now its biologics which i gather are like DMARDS: may work/ may not, may have bad side effects/ may work then stop working etc etc 🤦🏻‍♀️

Mmrr profile image
Mmrr in reply toBeelady

Fingers crossed you get a good result

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