cosjobs said:
I had psoriasis as a kid and it went away until I was in my early 30s. Then it came back with a vengance and I had it for over a decade.
My new dermatologist told me to try Embrel. She said that were no current known LT heath issues and I couldn't find anything bad on the internet, so I gave it a shot (actually two shots a week).
In about a month all the psoriasis was cleared up. Amazing.
Now I am supposed to start decreasing the injections until we find a maintenance dosage to prevent it from recurring.
I am hoping Genedoc reads this and tells me how it works and if there are longterm things I need to be aware of.
Hi Cos - Glad to see Enbrel is working well for you. As for the specific questions you asked, it's not a drug I'm immediately familiar with. Whenever that's the case, which is pretty often since I'm a researcher and not an MD or a pharmacist, I turn to rxlist.com, which describes Enbrel
here.
In short, it works by binding to a molecule called TNF in your body that mediates inflammation. It's a recombinant protein, so it's only available via injection. When something happens to your body - injury, exposure to a bacteria or virus, etc - your immune system responds in an number of ways, inflammation being a major response. When your immune system works properly, it responds with just the right amount of inflammation to deal with what caused it to become activated. However, in many case, the immune system can over respond, and when it does, bad things occur. Many forms of arthritis, lupus, asthma, psoriasis, and many other illnesses are at least in part due to immune system hyper responsiveness. If you can dial back the immune response a little bit, it usually helps the illness. However, figuring out exactly how to dial the immune system back 10-20% is a challenge, because if you dial it back too far, you're creating a bigger problem than you were trying to solve. So the challenge to the drug developer is to figure out a way to turn the immune response down without turning it off. High dose steroids like Prednisone do a good job of turning it "off", but the side effects are drastic. This is a over simplification, but the principals are what I was going for. If you've any other questions, I'll go into more detail.
As for side effects, it's a relatively new drug, so there's no long term data. The biggest warning I've seen is that if you become immunosuppressed for some other reason or develop an infection, Enbrel can exacerbate the problem because it suppresses the immune system. If you develop an infection of some sort, make sure you seek treatment for it and make sure to tell them of your Enbrel treatment. There have also been a couple of cases of lymphoma observed in the clinical trials. From rxlist (emphasis mine) : "9 lymphomas were observed in 5723 patients over approximately 11201 patient-years of therapy. This is 3-fold higher than that expected in the general population.
The role of anti-TNF therapy in contributing to these cases remains unclear". I'm no expert, but I'm guessing that people with immune related illnesses are already at higher risk for lymphomas (the lymph nodes are part of the immune system).
Every drug has side effects, this one looks no different than most. It's relatively new, so the risks remain unclear. As with every drug therapy, it's up to you and your MD to weigh the relative risks of treating the disorder and the potential side effects of the med vs. the benefit of the disorder being remedied. I know a LOT of arthritis sufferers who'd sign a waiver tomorrow to get Vioxx back on the market. Ask yourself and your doctor what are the risks, what are the benefits, and which is greater.
Hope this helps.
and that was completely out with that treatment as I discovered a few times after the regular blood tests said my liver was about to stage a revolt.
