RA + psoriasis. MTX allergy. Enbrel (etanercept) non effective. Humira semi-effective but Vectra score 30 with extreme fatigue. MD wants to try Xeljanz?

RA + psoriasis. There are a number of newer medications that could help you. Xeljanz works by disrupting cytokine and growth factor signaling pathways. A trial of the medication is useful to see whether it helps you. Other medications that might help include Remicade (infliximab) and Apremilast.

Related Questions

Dx:ra. Enbrel (etanercept) not effective after 6 mo. Humira 2x mo prescribed. Liver can not tolerate mtx. What medication can replace mtx to make humira work best?

See a rheumatologist. The only person who should be advising you on this is a doctor who is seeing you and examining you and has your entire medical history available. There are several ways to approach this and decisions must be made only after a face to face encounter. Hope you get this worked out soon. Best. Read more...
Ask re: wkly Humira (adalimumab) Leflunomide is another drug that is sometimes used instead of Methotrexate if Methotrexate is not tolerated. However, i rarely use it for patients who do not tolerate Methotrexate because it doesn't seem to work nearly as well (but other docs think it works fine). Instead, i would try increasing Humira (adalimumab) to weekly dosing of 40mg. This works for half of my patients who don't get relief from 2x/month. Read more...

Enbrel (etanercept) 50 mg sq x 3 months for RA + psoriasis. Very little improvement. Any downside to increasing to enbrel (etanercept) 50 mg sq twice weekly? Mtx not tolerated.

No real downside. Tnf inhibitors like Enbrel don't increase in toxicity like other meds do. Increasing the dose to 50mg twice weekly is a good idea.But, if you don't also take methotrexate, for any reason, you will be more likely to develop antibodies against the Enbrel and neutralize it--causing it to lose most or all effectiveness.If increasing Enbrel does not work, consider another med like Humira or remicade (infliximab). Read more...