Enbrel frequency

** Originally posted by cmorron **

Hello all -

I was on Enbrel for a year (25 mg 2x a week), off for pregnancy, then have been back on for 8 months (50 mg 1x a week). Last week I had a terrible cold and decided it was probably best to skip my shot for the week. Other than one day of mild pain in one joint (as opposed to the 4 or 5 joints that are afflicted with the PA), I felt fine! I am feeling better as far as my cold is concerned and did my shot again yesterday. So here's my question...

How often do you all administer Enbrel?
Do you think it would be just as effective if it was done once every other week?

I will talk further with my rheumy about this next time I go in (in January), but was just wondering if anyone else tinkered with the idea of reducing the freqency of the shots. I'd love to hear your thoughts! Thanks.

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** Originally posted by web63 **

I am on Enbrel for PA.
I am am double doses.
50mg 2x weekly
It would kill me if I were to slack off on mine.
I do not see a problem as Alli posted about going 8 to 10 days between shots.
BUT!!!!!!!!!!!!!!! As you know we are mere mortals, and the Rheumy should be the one to tell you this.


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** Originally posted by JesseLou **

I take MTX, not enbrel, but last year I skipped weekly shots for 2 1/2 weeks because of a bad cold. I didn't have an adverse effect (in my PA) until I missed the 3rd shot. Then it took me 2 months to get back to where I was before.

Just thinking that all of these systemic meds seem to work on a cumulative basis, so you might not notice changes right away.

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** Originally posted by Tat2U **

I take 50mg 2 x a week for Psoriasis. I also have PA.
I have stopped taking it because I want to become pregnant. Have been off it for 3 weeks and my P is definately multiplying. My joints are doing fine, although the PA was never bad to begin with.

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** Originally posted by SCCatman **

My understanding is that for P, you can decrease the frequency of the doses and taper off. It may or may not work. If I tried it I would continue to get the enbrel from the pharm, to be able to do it twice a week if I flaired.
My old derm would try to wean people off enbrel after they got cleared. You also need to decrease frequency (i.e. every 10 days, two weeks) as oppoed to decreasing dosage (25mg a week instead of 50mg). In other words 50mg every 2 weeks is OK, 25mg every week is bad. It can cause a bad flair!!!

For PA, you need to stay with the recommended dose.

If I miss a shot due to a cold, I take it as soon as I feel better. You can take shots 3 days apart. I normaly take mine on Saturday, but had to delay last weeks until Wendsday, took this weeks again on Saturday.


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** Originally posted by ericw10 **

I thought about this reduced dosing schedule as well since I didn't want to be THAT "supressed" for long periods. Lymphoma is not my idea of fun and wanted my system to be given a chance to stretch it's legs every so often for insurgent cell seek and destroy missions.

Bad idea, my Rhumy said. Why? Because after 10 days or so, the molecule is flushed from the system and things are allowed to reset. Once the molecule is re-introduced, the immune response is different and possibly more subdued. In effect, the system becomes tolerant of the molecule since it has already developed antibodies to it as the foreign protein it is. Ever wonder why immunizations are given in subsequent doses over weeks or months for full immunity to the pathogen? That's why.

It's the opposite effect from opiates etc where you become tolerant with continued usage. With Enbrel, you become tolerant by not using it continuously. Main reason is opiate tolerance is due to the liver becoming very good at metabolizing it, whereas Enbrel tolerance is due to immune cells quickly recognizing it after a lack of it.

I believe it since my Rhumy is one of the Directors of R&D that worked with Wyeth during development of the stuff. My advice is to inject as prescribed unless you are really faced with an infection requiring treatment. Becoming tolerant to Enbrel would be pretty devastating me thinks since it is the only thing that has really helped in 15 years of this crap.

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** Originally posted by SCCatman **

You also mention joint pain. My understanding is that for PA. Enbrel is a for life thing, or until a better treatment comes along

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