Have you taken more than one anti-TNF?  These drugs include:

1) Infliximab (Remicade)

2) Adalimumab (Humira)

3) Golimumab (Simponi)

4) Etanercept (Enbrel)

5) Certolizumab pegol (Cimzia)

Which order did you take them in?  What were your results?

My first biologic was Enbrel, which didn't seem to do much for me and I did not stay on it very long (1.5-2 months?).  Next, I tried Remicade and it worked very well for a short time.  I called it magic koolaid it worked so well.  However, within 5-6 months, it no longer worked at all.

My next biologic is up to me to pick after my recent infusion incident with Actemra.  I'm leaning towards Humira and would love to hear a victory on humira after trying remicade, but more than that, I'd love to hear your experiences with anti-TNFs.

There is a lot of clinical research out there showing that it probably makes sense to try multiple anti-TNF drugs, but the caveat is that the evidence seems to show that as you try and fail these drugs, the probability that you will have a good result on the next seems to decrease.

That may not make a lot of sense, given that they are all the same class of drug, but it turns out that while they all target cytokines through the manipulation of TNF-alpha, they have different methods of action (for example, they don't all work for crohn's disease due to chemical differences) and therefore failing off one (or two) doesn't mean the next one won't be your miracle drug, just that your chances of success are reduced.

If you think about it, however, that makes complete sense given that anti-TNFs are only effective for roughly 67% of patients.  Some of the people who try one of these drugs suceed on their first attempt.  Some people, do not, and try again with the next drug.  Keep in mind that 67% though.  For some of us (33% in fact), no anti-TNF is going to work and it simply doesn't matter how many are tried or in what order. 

So, on the first drug attempt, we are all in the same pot, but once you fail off a drug, you have a smaller chance for the next to work -- but that smaller probablity is impacted by the fact that the number of people for whom no anti-TNF drug will work is now *relatively* larger (because we just took all of those lucky souls who suceed on the first drug out of the pool).  As you keep moving down the line, this number continues to get larger and larger relative to the total number of people still trying anti-TNF drugs.

There is a lot of confusing evidence out there (especially in a 2011 paper) about whether taking a drug and out-right failing it (e.g. it never works) versus taking a drug, having an intial response, and then having the response fade to zero (e.g. it works like magic, but 5 months later it doesn't work at all) offers a better chance of success.  In fact, from what I could see, it depends on how you evaluate the disease (i.e. ACR vs. DAS vs. EULAR) as to which is better .  Ack.  Let's just go with 'the Jury's still out on this one' (although the initial evidence presented in 2005-2006 seemed to show you were better off if you had an initial response and then failed down the road.