Bringing Out the Big Guns (or Shots Anyways)



As I mentioned in a previous update, a couple month ago my joints started flaring badly. This is definitively on of the worse flares I have ever been in if not the worst. After a burst of prednisone did not stop it (well it helped till I weaned off of it) I went to see my rheumatologist.

At the appointment after describing my symptoms she mention Enbrel but wanted to do a physical exam first. If there was obvious signs of inflammation on the exam she would prescribe the medication but if not she was going to send me for an MRI to look for inflammation first. Well by the end of the exam there was no question my joints were not in good shape, Enbrel was prescribed.

We wrapped up the appointment by adding back in some lower dose Prednisone as well. Then the nurse came in to teach me how to do the Enbrel injections, super fun. Overall doing the injections is actually relatively simple.
Compared to an Infusion the Enbrel Supplies are Pretty Simple 

Now to get down to the nitty gritty of what exactly Enbrel is. The drug is part of a relatively new class of medications call Biologics. Enbrel was actually the first FDA approved Biologic. Biologics are used in the treatment of quite a few autoimmune disease and there are a few types. Enbrel in an TNF inhibitor. That means it suppresses TNF proteins, which are part of the immune system. In someone with autoimmune arthritis there is too much TNF from their over active immune system. Taking some of it away help bring down inflammation. However that also means Enbrel suppresses the immune system making it harder to fight off infections.
Enbrel and TNF in knee joint
Taken from the Enbrel Website
As far as side effects the most concerning is the suppressed immune system. I spend a lot of time with kids both in schools and as a nanny so I always have to be super careful and I go through lots of hand sanitizer. I also got headaches after my first couple injections but they seem be be getting better the longer I am on Enbrel. This week I had a site reaction for the first time but it did not show up till two days latter. This week I am going to try taking Benadryl prior to the injection to hopefully prevent any reactions.

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