Right up front here, let me make clear that I am far from an expert on this subject. In fact, I'm just beginning to learn about these biotech miracles and what I have discovered for myself has been both frightening and exciting. I guess it's a little like deciding to go to the moon. Worth the trip? Heck, yea! Without risk? Heck, no! I started Humira in September of last year and while methotrexate had helped me some providing me hope where I had none, Humira was a simple miracle. Within days, my pain and stiffness began to disappear; where every joint was painful and stiff, I could now count the on one hand (with actual moving fingers!) the number of joints that had pain and that pain was very tolerable. The injections took some getting used to, true, but now they just aren't that big of a deal. I can shake hands without pain. I can get out bed reasonably well. My stiffness is down to maybe 15 or 30 minutes in the morning as opposed to hours. And I could expect continued improvement!
Then, bang! Bronchitis! Now, we all know that biologics come with a long list of warnings and high on that list is an increased risk of infection. Afterall, what we are doing is slapping down our immune system to stop it from attacking our joints (and anything else it can find) and this can sometimes make us more open to infection, especially upper respritory infection. So, I go off to urgent care for breathing treatments, antibiotics, inhalers and cough meds. And I stop my Humira and MTX and the joint pain comes back. When the bronchitis is better, I'm back on my arthritis meds and the joints start feeling better and bang - bronchitis again - same sequence! Second time 5 months. Not good.
So off to my rheumatologist I go and we have a chat about this. I'm doing well on the Humira, my inflammation numbers are down, my anemia is improving, my liver numbers are holding their own and my joints are happy, happy, but I am having trouble staying on it because of the infections. This has been a hard winter for everyone with lots of upper respritory infections so it's possible that I won't continue at this rate. We decide to give it another 4 to 6 months and see if I continue to get sick or if I manage to stay well and on the medication. If my rate of infection continues, we will try switching to Enbrel.
Enbrel has a lower rate of infection than Humira does. Did you know this? I sure didn't! If you look at their websites it would be very difficult to discover the actual clinical rate of infection or do a comparison. After this conversation though, I did some research and there is some data that compares the different biologics and their infection risk and there is a real difference. Of course, this isn't the only thing that would guide our choices when we are trying to decide what biologic to try. If I were to select the safest biologic it would be of no use if it weren't effective for me and sometimes a biologic that works for one person won't work for another.