Trying Different Biologic Brands of Same Type
I have bad enthesitis and so far not much luck in reducing the pain after trying 5 different biologics, all which target different parts of the immune system. I was wondering if anyone has had relief by trying a different biologic in the same family? So the first one I tried was Humira, a TNF inhibitor. Would a different TNF inhibitor maybe have a better result? I'm assuming not because my doctor keeps trying biologics from different "classes" (I'm not sure that's the right word), but want to see what other people's experiences have been.
That will all depend upon who you ask. Some people who have poor response to Humira have had luck with Enbrel, and vice versa. Your immune system can develop antibodies to the biologics, and do so rather quickly. Since each biologics are a different formulation, even those within a same class, developing antibodies to one doesn't necessarily mean your body will do the same with another. However, some doctors prefer not to take the chance, and would rather just try a whole different other class of biologics, so long as the insurance company will allow this. Personally, I had great initial response with Enbrel, but zero response to Humira once Enbrel failed. When I was put on IL-17 inhibitors, Taltz did not work at all, but Cosentyx worked for about a year, though I still needed prednisone for flares. I'm currently on an IL-23 inhibitor, Skyrizi, and have had great success with that for well over a year now, and have even been flare free.
I know. Started to realize that recently and it's so depressing. But it could be much worse, so I'm grateful for any improvement at all. And it simply could be that you will see incremental gains, and over the long term, see overall improvement in your symptoms.
, I am glad that you raised this question. I have been wondering the same thing. , your insights are always appreciated.
I have an overlap of RA and PsA with uveitis. My rheumatologist is always looking to cover the 3. Some biologics help with Uveitis. That said, he has kept me in the TNF class of biologics -Humira, Cimzia and Simponi Aria infusions. I am spinning my wheels.
Simponi Aria is not working so he suggested going back to Cimzia or Humira. It's pointless in my opinion. They lost efficacy.
I politely suggested trying a new class of drugs that targets B cells, like Orencia.
He has mentioned that drugs will take longer to work if you are not biologically naive. Just putting that out there in case it helps others.While there is a greater chance of lack or loss of efficacy in biologic non naive patients, it simply is not true that all biologics will not work for biologic non naive patients. In fact, I can personally vouch for that. It is true that there is greater efficacy, both short and long term, in biologically naive patients though.
, you are correct and I didn't write clearly. My husband has been home from work for 2 days, coughing, sneezing and emitting great sighs of misery. It's distracting LOL. I am doing my best to be a patient nurse. No fever and a negative Covid test, thank goodness.
If I understood my rheumatologist correctly, he said that a person who has not been on a biologic might respond more quickly to the medication than someone who has been on several biologics. I had asked him when I might see symptom relief with Simponi Aria. It is my third biologic.
Because I have only been on TNF's, I have posed the question to him about moving to a different class of biologic. I have been on a JAK inhibitor. That landed me in the ER. I would like to avoid those.
Thanks for your response. It helped me clarify my post here.
