Biologics vs Mtx injections

[Gitaga]

Hi.

Rheumy suggested that I go on biologics. I believe that the side effects are considerable. Also seeing that it is newer than mtx, I very sceptical.

Just to say that I also been diagnosed with CKD

Can I get your views.

TIA

[oldtimer]

It's sensible to get information about other treatments before agreeing to them. Any long-term condition needs to be managed day to day by the individual with expert input from the professionals.

Rather than anecdotal impressions from individuals who may not be like yourself, it's good to get information from unbiased sources such as NRAS: nras.org.uk/treatment

or Versus Arthritis who have a more general take on arthritis or various types: versusarthritis.org

Most of the biological treatments have been around long enough for the adverse effects to become apparent (and there are, as you know, always downsides to anything that works!) You don't say how severe your kidney damage is, so it's difficult to know if that would affect your choice, but presumably the rheumatologist is aware of that complication?

You don't say which biological treatment is being suggested either and there are lots now to choose from.

[Gitaga in reply to oldtimer]

Thank you. Your response was very helpful

[AgedCrone]

No the side-effects of biologics are not considerable ....unless you are extremely unlucky most people do very well on them.

Presumably as you have kidney involvement your Renal Consultant will be liaising with your rheumatologist?

There are many different Biologic drugs....Its likely your rheumatologist will explain those he chooses that would suit you, and explain the difference and how each one acts on the type of rheumatoid arthritis you have, You would be wise to listen to him and take his advice.

Yes ....they are much newer than methotrexate which has been around for about ?30 years now...and is still considered the gold standard drug given for RA.

Personally I took it for seven years extremely successfully.

A lot of people also do very well on it....... unfortunately the ones you usually read about are the ones who do not do so well.

If both your doctors recommend a Biologic drug...I hope you do well in it,

[Gitaga in reply to AgedCrone]

Thank you. Appreciate your response.

[helixhelix]

I moved from conventional DMARDs to biologics about 2 years ago. I was extremely hesitant, not because of the side effects which are said to be far fewer, but because of the increased risks of serious infection.

We each have to weight up the pros and cons of treatments and make our own decisions. All I can say is that I did change to biologics in the end, and am very happy I did!

[Gitaga in reply to helixhelix]

Thank you for that. Really hope it works for me.

[medway-lady]

I have CKD too (since Oct 2018) and the Nephrologist does agree to RA meds. But its not really a big issue as AZA and LEF are used anyway in Renal transplants. In my case Omeprazole caused my AKI which has progressed to CKD eGFR 26%. I'm on AZA and Etanercept (Biologic its fine. so don't worry to much) Your Renal Team will have given you the name and phone number of the Renal Pharmacist to run any drugs by. Which I do and even the GP has said ring Renal Team as not sure and its such a specialised field. I've honestly never had a problem with RA meds a couple of others I've rung about the pharmacist said no don't take or its a reduced dose because of kidney function.

I think you need to talk to Nephrologist as he/she will have the priority decision on your medications but they do talk to the RA team. I promise you the letters get copied in to GP, RA Consultant and Nephrologist and I reckon that I probably get better treatment as a result.

[Gitaga in reply to medway-lady]

Yes they do consult . Can I ask. Are u just on biologics. Or is this paired with another immunosuppressant.

[medway-lady in reply to Gitaga]

Yes the biologic is Etanercept with Azathyoprine (DMARD) honest its fine. As I said if in doubt ring Renal Pharmacy. But just a warning it always seem to take a bit longer as these days communication is harder. Although I'm under 2 hospitals rather than 2 departments of the same hospital.

I do understand what your worried as its no longer straightforward as CKD affects drug elimination so don't go by what others say is ok, as your choices may be more limited, mine certainly were. I'm happy to chat if you PM me but can't advise you about what might be good or not as its down to the RA consultant and the Nephrologist. But take heart I'm in remission and live a normal life.

[Gitaga in reply to medway-lady]

Cool thank you 💗💗

[Knit12]

It is important that you find the right medication, methotrexate is obviously not working for you when your rheumatologist has suggested biologics. I’m on my third biologic each with varying side effects, though I have to say the side effects I had from methotrexate were far worse. Everyone is different so you have to try and see what suits you best

[Gitaga in reply to Knit12]

Yes. I suppose one has too. My Nephrologist did say that the next step in my RA treatment would possibly be biologics. 🤷‍♀️

[MadBunny]

I've been on a biologic for 6 years and have done very well on it. To use a cliche it has given me my life back as the mtx had stopped working and I was struggling and in pain. I was very worried initially. Ive never had any side effects that I can think of. And luckily have not had any more infections than usual. As others have said, everyone is different. I saw the biologic specialist nurse and she explained everything in great detail.

[Gitaga in reply to MadBunny]

That's good to hear. So is this the only meds you take?

[MadBunny in reply to Gitaga]

I also take 10 mg mtx a week but the nurse was talking about possibly reducing that last time I saw her.

The biologic I'm on is Cimzia. I was lucky it worked for me. I inject it myself every 2 weeks. Scary at first but now no problem.

[Pythagorus]

I am on both methotrexate 12 years and Benepali 2 years and have no side effects at all except for keeping the RA at bay. I wish you well.

[Gitaga in reply to Pythagorus]

Wonderful. Thanks for your response

[Hessie5]

Hi - when my RA was running rampant and my pain was off the scale I I didn't care if they injected me with horse tranquillizer!! Yes, that how bad it was for me - I begged my Rheumy to give me something to rid the pain 😭 that engulfed me.

I went through 8 biologics to find one that helped. I am on a biologic and pray I do not go back to those awful pain days - (brings tears to my eyes).

For me it was choice and having quality of life. I thank God everyday as life is great and lots to be thankful for. 😌

[Gitaga in reply to Hessie5]

I was like that 3 weeks ago 😭. Thank you for your response.

[Gitaga]

Thank you. Sounds promising 👌