Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group Remicade New - Enbrel Old

Hi ya Kat,

Long time. Too long.

Your amazing. Sounds like Remicade is working for you big time. I remember reading your posts when you first started it. Is your progress still improving? I'll bet your dancing up a storm. I hope so.

I'm so happy to hear your doing well.

Fred

Hey Fred, this is my first time going the full 8 weeks between infusions. This has coincided with the change in weather to a cold, damp Canadian autumn season. This, in a word, SUCKS!!!

I still have better mobility than pre-Remicade, but I'm really feeling the weather. Tons. Hips/SIs, shoulders, thoracics, ankles, toes, fingers. I've started taking Tylenol Arthritis before bed at night, which helps some, but last night, for the first time in ages I actually woke up as I rolled over as my lower back was so sore. I think I'm going to have to give in and take the Ty Arth during the day too. If that doesn't do it, I'm not sure what to do. If only we could have some sunshine for a few days, I know that would help immeasurably.

That said, Fred, I am most definitely still dancing up a storm - and doing pilates - and working out three days a week - and volunteering for The Arthritis Society - and seeing my sweetie . I will not stop unless my body makes me (I'm far too stubborn); although, I am making sure to have more time for just plain rest than I have of late.

Ah well, I'm still better off than I was before ... by a long shot!

Hugs,

to to my understanding, recombinant human proteins can still be immunogenic for humans, although less so than recombinant proteins whose sequences are derived from other species.

http://www.ncbi.nlm.nih.gov/entrez/query...t_uids=15852250
Anderson PJ.
Tumor necrosis factor inhibitors: clinical implications of their different immunogenicity profiles.
Semin Arthritis Rheum. 2005 Apr;34(5 Suppl1):19-22. Review.
PMID: 15852250

from full text:
"...Infliximab and adalimumab are monoclonal antibodies that bind to, and neutralize the activity of, TNF-α. Infliximab is a mouse/human chimera that joins the variable regions of a mouse antibody to the constant region of human IgG1 (5). Adalimumab is a fully human IgG1 antibody (6). Etanercept is a dimeric fusion protein that joins the human p75 TNF receptor to the Fc domain of human IgG1 (7). Structural differences in these drugs influence their immunogenicity. Because the amino acid sequence of mouse proteins is usually different from their human counterparts, mouse proteins tend to be immunogenic. Patients treated with mouse:human chimeric antibodies can develop human anti-mouse antibodies (HAMA), which may reduce the clinical effectiveness of the drug. Patients treated with fully human antibodies can develop human antihuman antibodies (HAHA). These antibodies bind to the unique antigen-binding site to which the immune system is not been tolerized (Fig. 2). Patients treated with TNF receptor:IgG chimeras can develop antibodies directed at the junction between the TNF receptor and the Fc domain of IgG....


Adalimumab
Adalimumab appears to be less immunogenic than infliximab. In 3 randomized trials, the cumulative incidence of anti-adalimumab antibodies in 1062 patients with rheumatoid arthritis was 6% (16). The incidence of antibodies was greater at lower doses than at higher doses (6% with doses of 20 mg every 2 weeks and 5% with doses of 40 mg every 2 weeks), and among patients receiving biweekly doses (6%) versus weekly doses (4%). Concomitant methotrexate therapy was associated with a reduced incidence of antibody development; 12% of patients treated with adalimumab alone were antibody-positive versus 1% of patients treated with adalimumab plus methotrexate. Weinblatt and coworkers (17) similarly reported an incidence of anti-adalimumab antibodies of <1% in patients given concomitant methotrexate.

The cumulative incidence of antibody formation is relatively low in this pooled adalimumab analysis compared with the infliximab study described above. However, several factors prevent direct comparison, including the diverse patient populations studied (rheumatoid arthritis versus Crohn’s disease) and the possible lack of standardization in the assay methods used (double-capture enzyme-linked immunosorbent assay) (6).
"

I felt the effects the first night. I was giddy. Been over a year and half and it is still helping. Keeping in mind I've had 33 years of damage so I'm still walking as anyone with structual damage would. It takes that initial edge of discomfort off (for me). Before I had to contemplate getting up out of a chair and get phyched up for the discomfort. Now I just stand up and feel my pain after I start walking. I get the post infusion duldrums for a day or two afterwards but that is it. No other side effects to report. If anything it has helped in other areas. I get far less episodes of Iritis and my bowels have settled down quite a bit. Good luck.

Kerry

Well Fred seems we are following a similar path. Enbrel worked for a year and then stopped. Have been surviving for the last year but past 6 months have been the worst flare I have ever had.

Finally decided needed to either look at remicade or humira or quit working. Went to a new rheumy and he put me on a tapered pred dose to stop the flare and started remicade last Friday. Was better after the pred pack and have not reverted so hopefully the remicade is working. Will know better by Thanksgiving because I have an 8 hour trip to NC planned for the weekend before. Will survive it one way or the other but that will definitely tell me if it is working.