“Sometimes the antibodies produced in response to a biologic have no effect. Other times they bind and inactivate the biologic, causing disease progression. In still other cases, they can bind to and inactivate a patient’s naturally occurring protein, which means that the patient may be left with no options other than regular blood transfusions.”
Is this perhaps why MTX is often prescribed alongside a biologic such as Enbrel?
Yes, I have been told about the 1st 2 but not the third statement. I was told that there have not been any trials completed but statistically patients taking MTX along with a biologic/biosimilar last longer on the bio before efficacy reduces. It is thought that this is related to patients developing antibodies to the bio and MTX inhibiting that process.
That's more or less what I was told, mtx stops your body making antibodies against enbrel, which makes enbrel work longer. I've just had my mtx reduced to 10mg (I've been in remission for years), next time I see my consultant I'm going to ask what is the lowest dose that you can take along with enbrel.
I never knew that MTX could prevent such problems with biologic drugs. I have been on biologics since July but not on MTX, so the chance of requiring regular transfusions is not a happy idea at all!
Hi Charisma, I too was unaware of that downside until I happened upon it and created the above post accordingly.
Without checking, I would hazard a guess that it is a very rare outcome. It sounds so undesirable (and expensive for the health service) that it cannot be a frequent occurrence.
I understand that Mtx is often used with a biologic to suppress your immune system overall to make the biologics effect last longer because the immune system is trying to get rid of it.
I think you may be right, Agoodlife, albeit there is some doubt about how it works.
I found this
"Fundamental mechanisms underlying the therapeutic effect of high doses MTX on malignant diseases are currently well established; MTX as a folate antagonist, competitively inhibits the activity of folate-dependent enzymes and synthesis of purine and pyrimidine required for DNA and RNA production in rapidly dividing malignant cells [14]. However, mechanisms by which low-dose MTX exerts its therapeutic effect in inflammatory disorders are not completely elucidated."
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