DMARDs for Arthritis Q & A

After being on Leflunomide for about 3 months, I developed a very severe itching all over my trunk – front and back. I have scratched so much, my skin is bruised and I have given myself a rash from the scratching. As Lefl. was the last med introduced, my doctor suggested I stop it two days ago, which I did, but the itching is still driving me crazy. I have also been taking Enbrel and prednisone. I have failed methotrexate and sulfasalazine. I think the Lefl. was helping me so I am very concerned about dropping it at the same time I am trying to taper off the prednisone I have been on for over a year now. I do have a significant history of allergies, get hives from Benadryl (seriously) and I am having what my doctor calls “recall reactions” when I take my Enbrel shots. If this itching is indeed from the leflunomide, how long before the itching goes away? Or do you think it could be from the enbrel? He says it can’t be the prednisone.

I am reading about TNF blockers such as Humira, Enbrel, Remicade and others. I have crohns and was just wondering what the difference is in the different types of TNF blockers and why they work for some illnesses and not others. What is the difference in Enbrel or Humira vs, Remicade that it will not work for crohns? Just trying to lower my medical bills.

I am 25 years old and had been on methatrexate since September 2004 and have just been taken off it(January 2006). Over the last year I had noticed that I had become forgetful-forgetting simple things(like putting something down and not remembering where I had put it two minutes later). I had worried a little about it but didn’t make any connection with my medication. I met a lady the other day who had been on methatrexate for RA and she had to come off it as she had become very forgetful. Do you know if there are any links between methtrexate and memory loss? If so, does memory tend to come back after coming off drug?

I am a member of an online chat forum and a conversation came up recently. Someone stated that when you take the weekly dose of metho, that it wears out of your system on 10hr sessions and is basicly gone within 24hrs. If this is so, why does the med last for the entire week? Is it that it makes your body alternate itself in some way that it takes the week to start itself changing back to normal? We thought it stayed in your system for that long, but recent conversations say otherwise. Also, besides the regular stomach upsets from taking the pill, how rare are the harsh effects like liver damage etc. Less than 1%? 5%?

I have advanced psoriatic spondylitis. Enbrel has kept it under control for the past three years but I still have debilitating flares a few times a year. I can’t take prednisone anymore because trying to get off the drug now always throws me into a worse flare than what I started with. I can’t take methotrexate or sulfasalazine because my body doesn’t respond to them anymore – I’ve failed them as the doctors like to tell me. As I was reading about Kineret and Orencia I got the bright idea of trying one of them in addition to my Enbrel to try to stop a flare since they are not TNF alpha inhibitors. I am on disability and could play hermit during the trial – I can’t get out much when a flare has me down anyway – to help with any concerns of lowered resistance to infection. My immune system is so overactive I’ve never experienced the problem before anyway. Do you think combining Enbrel and Kineret or Orencia might help stop a flare?

Do you have any experience with using these drugs simultaneously? What happened with the length of time of B cell depletion? CD4 count? Infections?