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When Is It Appropriate To Switch Your TNF Blocker Drug?

By , About.com Guide

Updated July 05, 2006

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Question: When Is It Appropriate To Switch Your TNF Blocker Drug?
If an arthritis patient is on one of the TNF blocker drugs, when is it appropriate to switch to another? Is it possible for a patient to respond differently to another TNF blocker drug?

Can a patient go back on one of the TNF blocker drugs after having stopped treatment?

We mostly hear about the TNF blockers, Enbrel (etanercept), Remicade (infliximab) and Humira (adalimumab), but are some arthritis patients doing well with the biologic IL-1 antagonist Kineret (anakinra)?

Answer:

Starting TNF Blocker Drugs (Enbrel, Remicade, Humira)

At least 70 percent of patients with rheumatoid arthritis who start one of the TNF blocker drugs - Enbrel (etanercept), Remicade (infliximab), or Humira (adalimumab) - will get significant improvement in their condition.

Even more patients will get benefit when methotrexate (Rheumatrex, Trexall) or another DMARD (disease-modifying anti-rheumatic drug) is combined with treatment.

  • The TNF Blocker Drugs (Enbrel, Remicade, Humira) - Test Your Knowledge
  • Rheumatoid Arthritis - Test Your Knowledge
  • The Facts Of DMARDs (disease-modifying anti-rheumatic drugs)
  • Methotrexate For Rheumatoid Arthritis
  • Switching TNF Blocker Drugs (Enbrel, Remicade, Humira)

    If a patient does not respond to the initial TNF blocker after 3 months, switching to another will increase their chance of benefit.

    In fact, even if a patient has not responded to two of the TNF blocker drugs, the third still might be useful.

  • Enbrel, Remicade, and Humira - How Are The Drugs Similar And Different?
  • Side Effects Of Enbrel, Remicade, And Humira - Weighing The Risk Vs Benefits
  • TNF Blocker Drugs & Skin Disease
  • Why Is There An Increased Risk Of Infection Which Occurs With The TNF Blockers?
  • Kineret (Anakinra)

    Most rheumatolgists have not used Kineret (anakinra) commonly to treat rheumatoid arthritis due to its decreased effectiveness and need to inject daily.

    Kineret has been very useful in those patients who have been diagnosed with a systemic form of juvenile arthritis called Still's disease.

  • Does My Child Have Arthritis? - Juvenile Arthritis Screening Quiz
  • Juvenile Arthritis: Arthritis Is A Children's Disease Too
  • Guide to Juvenile Rheumatoid Arthritis
  • If You Stopped TNF Blocker Drug Treatment

    While patients who have stopped treatment with Enbrel and Humira can go back on the drug without concern, those who have been off Remicade for a prolonged period of time face the risk of infusion reactions which may be dangerous.

    Related Resources - TNF Blocker Drugs

  • TNF Blocker Drugs / BRMs (Biologic Response Modifiers)
  • TNF Blocker Drugs (Enbrel, Remicade, Humira) - Test Your Knowledge
  • Arthritis Medications (Drug Information & Side Effects)
  • Arthritis Medications - Test Your Knowledge
  • Arthritis Drugs: What Are My Options?
  • Answer provided by Scott J. Zashin, M.D., clinical assistant professor at University of Texas Southwestern Medical School, Division of Rheumatology, in Dallas, Texas. Dr. Zashin is also an attending physician at Presbyterian Hospitals of Dallas and Plano. He is a fellow of the American College of Physicians and the American College of Rheumatology and a member of the American Medical Association. Dr. Zashin is author of Arthritis Without Pain - The Miracle Of Anti-TNF Blockers. The book is a must-have for anyone on one of the biologic drugs (Enbrel, Remicade, Humira) or considering the biologic drugs. Read our review of the book.

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