Hi
please could anyone let me know if they have changed from mtx tablets to Idacio ?
I was told that you still have to take mtx tablets but at a lower dose with Idacio ?
I was told biologics can work within a couple of weeks ??
I don't know if I want to go down the biologics route yet, I am a bit scared of how more immunosupressed they make you. I don't want to be afraid of gardening or going on holiday..
please could anyone advise on their experience of adalimumab/ Idacio ?
many thanks
I'm on my third biologic - never had a serious infection on them. I can't say that means you won't, but I think if you take care and follow the advice then I'm proof it can be avoided. And I'm a keen allotmenteer, so no need to worry about gardening.
The reason I'm on my third is that the first two stopped working after about 9 months each time. I wasn't taking methotrexate at first.
The idea is that a low dose of methotrexate will augment the biologic and also help stop you building tolerance to it, so it works for longer.
I now take 12.5mg methotrexate with my current biologic and really feel like it's helped improve its efficacy. I did have a setback recently where I thought it wasn't working anymore but seemed to be temporary and perhaps a response to having a bad dose of Covid. Who knows.
It's your decision, but I really wouldn't worry about biologics generally. They can be life-changing, in the best way.
I've been on Humiea, original adalimumab, and 9 years alongside mtx and never had any problems. I can't remember last time I've had a cold. Never stopped me travelling either. I've been to places like Morocco and Tunisia as well which included the Sahara desert and Atlas Mountains trips. All they mean is if we do do xatch something we need to be more careful like needing antibiotics same day and stopping meds if ill. X
I've been on adalimumab since 2006. I've had no problems with infections. I catch them, but no more often than before and no worse. I garden regularly and have an allotment. I also go on holidays and have never picked up anything more than anyone else I have travelled with. I was able to reduce my methotrexate from 20mg to 10mg. Adalimumab transformed my life, without it I wouldn't be able to lift a kitchen fork never mind a garden one.
It is a misconception that the biologics make you more suppressed. MTX targets the whole immune system. Biologics target one of the many cytokines involved in inflammation and your immune system, which is the TNF cytokine. I’ve had far less infections in the 6yrs I’ve been using biologics. Before my body was too busy fighting the inflammation that it missed infections sneaking in.
MTX not everyone continues, but it is thought to reduce the chance of your body developing antibodies to the biologic. I take 25mg in addition to my biologic, with no ill effects. I was already using MTX when they started my biologic. Initially I was told to stop but my hands and feet quickly flared, so it was restarted. I still lead a normal life, and managed to work on the frontline nhs, nursing many infections over the winter without succumbing to them. If you don’t get on with the biologic you can just stop it, you don’t have to wean off. I would definitely give it a try, I wish I’d been offered years earlier before my sacroiliac joints and ribs fused. 🤗
thank you, I am due to have elective surgery this year, does that mean that I cannot take biologics? and do you know what the criteria is for being offered biologics ?
yes you have to stop biologics prior to surgery. The length of time you have to stop, depends on the half life of the drug. It takes 5.5 x Half life to clear it from your system for surgery.
Eligibility depends on your condition. I have AS where you need to fail 2 nsaids at max dose, have a basdi disease activity score >4, and an mri showing significant active inflammation. For RA you need a DAS score >5.1, as well as having failed 2 dmards, one of which must be MTX for at least 6 months, unless it is contraindicated for some reason. The DAS score as you’re probably aware is based on 28 joints, none of which include the toe joints for some reason. Hope this answers your query. 🤗
Hi, how can I find out more about the DAS score and how it works? my cons said my RA was not active but both u/s and mri have just confirmed it is active..they have not given me steroids to stop the flare whilst the drugs get re-evaluated..I am scared for my joints..
here’s a link that explains it, they mainly use the DAS28 in this country. If you have a smartphone there is also an app called rheumahelper that calculates it for you.
arthritis-health.com/glossa...
many thanks, I checked the NICE website and it has relaxed the rules for biologics, but still not sure if I would get it yet..
I've had hip replacement on biologics and had yo miss 2 doses of my humira and restarted 2 weeks afterwards. I'm waiting again for an op again and this time same with my humira but only need to miss one dose of mtx week of op. X
thanks that#s good to know, I have ops planned but thanks to a flare which has not been treated quickly enough I think my op will be postponed..
thank you so much, I have stopped hydroxychloroquine and had my mtx changed from 15mg tabs to 10mg pens for the last few weeks now but RA is active and joints getting more painful every day. mtx causes oral problems even with daily folic acid so I was wondering if I had to take a dmard if I went on biologics what other dmard could be used..
We take a dmard, alongside biologics, to stop the body building up resistance and make it work better. X
I have AS, and it’s mainly MTX used with biologics. A few use Sulphasalazine. It does help my peripheral joints, but it’s also intended to prevent building antibodies to the biologic. I’m still on the same biologic 6yrs later, so it seems to work. I would imagine with RA Leflunomide would be another option
many thanks, I don't know if I would be alergic to Sulphasalazine, guess it's trial and error
I have been on methotrexate for 6 years. Idacio was added 18 months ago when methotrexate stopped working so well. I had an almost immediate improvement. I have recently returned from a visit to Australia with no ill effects. Rarely get ill but did succumb to COVID last November but it was like having a bad cold.
For me adalumimab has been marvellous after all these years of pain and incapacity (didn't get it until the NICE recommendations lowered the barriers to access). I have not had any more infections than before and I try to lead a 'normal' social life which exposes me to risk.
I feel that it is better to have small doses of bugs from people on a frequent basis and keep my immune system ticking over to protect me. I did notice that while Covid restrictions were applied I didn't have infections with an upsurge immediately afterwards.
The aim of immune suppressants in Rheumatoid Arthritis therapy is to to reduce your immune overactivity to more 'normal' levels like in the general population not to supress it so much (as you do in cancer treatment) that you need to isolate.
ok thanks do you still take mtx ?
I'm on azathioprine not methotrexate as my DMARD. And yes it has been continued at a lower dose.
hi
I started idacio in Nov 2022. Mtx stopped working and started causing problems with side effects. I have stopped mtx altogether and am much better on my biological! I still gave a way to go but improving each dose. Good luck with whichever way you go!
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