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Have you ever taken Enbrel?
April 25, 2011 10:06 AM   Subscribe

I may start taking Enbrel to treat moderate-to-severe psoriasis (no - knock on wood - arthritis to date), and I'm wondering if anyone here has experience with it.

Did it work? Were there any side effects, and if so how bad were they? I've already taken and passed all of the precautionary tests, and it looks like my insurance will cover most if not all of the cost, but I'm a bit concerned about the immune system suppression aspect of the drug and wonder if it's worth taking for reasons that are largely aesthetic. I mean, it sucks and I'd be happy to be rid of it, but I've also grown largely used to it and my wife says it's not an issue with her.

Background; I've had psoriasis for 12 years, responded fairly well to UV treatment (which is, however, inconvenient, and my wife worries about skin cancer), but none of the creams I've been prescribed were very effective (or practical, because I've got it all over my body).
posted by The Card Cheat to Health & Fitness (11 answers total) 7 users marked this as a favorite
 
I took Enbrel for psoriasis several years ago. This was back in the day when you had to mix it yourself and inject twice a week. If I recall correctly, now it should be pre-mixed in the syringes and administered only once a week. I do remember that the newer, pre-mixed version burned a little as it went in, but otherwise the process was simple and painless.

As for results, it was a MIRACLE for me. I was on it for about 5 months, but I was almost completely clear after about three weeks. I've only had minor spot flare-ups here and there for the past four years. Didn't have any noticeable physical side effects. Your doc should being doing blood work pretty regularly, and will obviously adjust your plan of attack if he sees any adverse effects.

Good luck!
posted by kmtiszen at 10:48 AM on April 25, 2011


I take Enbrel for psoriatic arthritis. It's been great.

The negatives I have experienced:

1) The insurance approval was arduous enough to effectively delay my being able to start it for many months after its being prescribed.
2) Even with insurance, it costs me $300+ a month (which I can pay through my FSA, but which will be less possible in a few years when FSAs are capped at $2500).
3) The only medical negative is the (relatively) slight immunosuppressive effect. I have definitely noticed that I catch colds a little easier and hold onto them a little longer.

Overall I think it's been wonderful and worth the tradeoffs. But my case is different because it's for the arthritis, which was painful and limited my physical mobility. On the other hand, I am back to running (10 mile race this weekend, e.g.) so the drug really is very effective.
posted by Pax at 11:09 AM on April 25, 2011


I take Humira, another TNF inhibitor, for Psoriatic Arthritis with amazing side effects for my psoriasis. Humira is nothing short of amazing. I combine it with a NSAID, currently Meloxicam.

I use the autoinjector pin every other week. It costs about $2k a month, but my insurance covers most of it, so I only pay a $35 copay every month. I got a TB test but have not had any infections, and those aren't really stuff to worry about unless you live in certain areas or are elderly/young/etc.

You don't care about the arthritis, which is the main benefit I get from it, but within a few days of starting Humira, my psoriasis was probably 90% gone.

Better living through chemistry. Psoriasis sucks but TNF inhibitors are absolute magic.
posted by charlesv at 11:19 AM on April 25, 2011


I also take Enbrel for psoriatic arthritis. It hasn't made much of a difference as far as my skin goes, but it was amazingly effective on the arthritis. Like, from pretty much constant low-level pain to pain-free.

I haven't had any side effects, although I'm currently off it because I'm dealing with an infection. Once that's cleared up, though, I expect to go back on it. (This is the first time I've had to go off the medication since I started it about 2 years ago.)

One note on the cost: take a look at the manufacturer's assistance program. My health insurance covered a month's supply with a $100 copay; once I went on the assistance program, it cost me nothing for the first 6 months of the year, and only a $10 copay per month after that. So far as I can tell from the enrollment process, the only thing that disqualifies you from joining the assistance program is receiving government-paid health insurance (Medicaid, Medicare, or VA). I'm not quite sure what the manufacturer's percentage is in basically providing me the medication for free, but I'm not going to complain.
posted by asterix at 11:21 AM on April 25, 2011


Echoing kmtiszen above, Enbrel has been a miracle for me, too. Almost all of my patches are gone, my fingernails are back to normal, and the arthritis is vastly diminished. Haven't had a problem with colds or flu either, in the three plus years I've been on the drug. Highly recommended.
posted by GamblingBlues at 11:43 AM on April 25, 2011


Oh, one other thing: have you considered methotrexate instead of Enbrel? It's been far more effective for me in treating my skin, it's much less expensive, and since it's a pill rather than an injection it's easier to administer (not that Enbrel's that difficult) and travel with (since Enbrel needs to be refrigerated). The only downside is that since it can affect liver function you have to have blood tests once a quarter and you can't drink as much as you (might) want to.
posted by asterix at 11:50 AM on April 25, 2011


A former co-worker took Enbrel for something other than psoriasis. She talked a lot about her various issues with the medicine, so I feel free in passing them along.

1. The main thing she had problems with was logistics. She had to have it delivered from a specialty pharmacy due to the way our insurance worked. It has to be kept cold, so it had to be delivered to the office and she had to keep it in the fridge there until she went home (and then of course she had to go right home and put it away, no going out). I guess you could just put a cooler out and hope for the best or a little fridge that locks or something but it's something to keep in mind (unless it will be administered in the office; I think she had the option to do that but chose not to).

2. She became a super-carrier. My perception was that she didn't pay great attention to having healthful behaviors anyway (she was a party girl) but when she got sick, it was the most virulent, most awful sickness you could imagine. I honestly cannot believe she didn't get SARS and then give it to the whole office. Depending on how you are with catching things? But wash your hands. Wash your hands anyway. (Related/Unrelated: right after his sinus surgery when he was healing, my husband kept a giant thing of hand sanitizer at his desk and Clorox wipes, and encouraged his coworkers to keep it less germy so he wouldn't get an infection. Co-workers were nice about it and he didn't get sick. It's an idea if you're worried.)

Other than that, she was fine with it. She just didn't particularly enjoy giving herself shots, but she didn't enjoy her weird disease, either, so it was a trade off.
posted by Medieval Maven at 11:56 AM on April 25, 2011


The main thing she had problems with was logistics. She had to have it delivered from a specialty pharmacy due to the way our insurance worked. It has to be kept cold, so it had to be delivered to the office and she had to keep it in the fridge there until she went home (and then of course she had to go right home and put it away, no going out). I guess you could just put a cooler out and hope for the best or a little fridge that locks or something but it's something to keep in mind (unless it will be administered in the office; I think she had the option to do that but chose not to).

Your coworker was probably being overly cautious. I get mine shipped to my office (it comes in a cooler with ice packs) and I've inadvertently left it at work a couple of times; both times I called the pharmacy and they assured me that it's fine. I've also traveled with it in an insulated lunchbox; I wrap it in bubble wrap and pack a couple of reusable ice packs.
posted by asterix at 12:08 PM on April 25, 2011 [1 favorite]


The main thing she had problems with was logistics. She had to have it delivered from a specialty pharmacy due to the way our insurance worked. It has to be kept cold, so it had to be delivered to the office and she had to keep it in the fridge there until she went home (and then of course she had to go right home and put it away, no going out). I guess you could just put a cooler out and hope for the best or a little fridge that locks or something but it's something to keep in mind (unless it will be administered in the office; I think she had the option to do that but chose not to).

Anecdotal evidence, but I recently moved to Australia and packed six months worth of Enbrel supply (sure-click syringes) into a soft-sided lunchbox thing, with the intention of throwing an ice pack in there before I left for the airport. I forgot the ice pack, and spent something like 25 hours in transit* before I could get to a refrigerator to house my syringes again. As far as I can tell (I've been here about 13 weeks, so 13 doses), the syringes were fine. They shouldn't be exposed to extreme heat, or room temps for many, many hours on end, but it's not going to turn them if you want to stop for a beer on your way home from work.

*to be fair, the lunchbox was in my checked bag, and I hear it can get pretty cold in cargo hold, but I had no idea if it would keep without the ice pack, and it did.
posted by GamblingBlues at 3:39 PM on April 25, 2011


I use Enbrel to treat my PA, and it works a treat. I haven't personally noticed too much immunosuppressive trouble-- I didn't get sick all winter (so rare for me). I did though get a flu shot this year, which must have helped.

I was going to suggest you continue the UV treatment if that works for you, since I'd heard that psoriasis sufferers have a lower chance of getting skin cancer. It looks like that's no longer true though.
posted by travertina at 8:58 AM on April 26, 2011


Thanks, everyone! Very helpful.
posted by The Card Cheat at 6:56 AM on April 27, 2011


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