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November 19, 2008

Humira Welcome Package Arrives

In Canada, support services are provided by the Progress Program for Canadian patients with Rheumatoid Arthritis, Psoriatic Arthritis, Psoriasis, Ankylosing Spondylitis, or Crohn's taking Humira. They have nurses available around the clock to answer any questions, as well as cost reimbursement specialist to assist patients in optimizing reimbursement of Humira.

My Humira Starter Kit arrived today by FedEx from my Support Specialist at the Progress Program. Inside was a 2-compartment bag containing a journal, Humira Treatment Guide, 5 Steps card, an information booklet, a magnetic compliance device, a Medical Alert card, a Progress magnet, a DVD, Welcome card, demo auto-injector pen, a cooler bag, a reusable ice pack, and a Sharps disposable container.

I am now awaiting their pharmacy to deliver the medication to my home, and a home-care nurse to visit and walk me through using Humira. I have been reading about others' experience switching to Humira from Enbrel. The pattern has been that Enbrel initially relieves the disabling symptoms, but the relief wears off. Noticeable improvement occurs for most after switching to Humira. This is not to say that the same thing won't happen with Humira, or any other biologic; perhaps the beneficial effects are time limited. Unfortunately, we are the guinea pigs for long-term studies on this group of medications.

November 17, 2008

Still waiting

Well, I'm still waiting for the Humira to arrive. A community agency representative contacted me today to confirm that my private health benefits will cover 90% of the cost of the medication. She indicated Humira costs approximately $1600 each month (that's only two injections), so any reprieve from the full expense is a blessing.

I found a Canadian health advisory for Humira that I thought may interest readers:

HEALTH CANADA ADVISORY

January 13, 2006

Health Canada has issued new warnings concerning the use of Humira(adalimumab). To read the full Health Canada Advisory, visit Health Canada's web site at: http://www.hc-sc.gc.ca.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Allergic reactions: In rare cases, some people may develop an allergic reaction to this medication. Signs of an allergic reaction include a severe rash, hives, swollen face or throat, or difficulty breathing. If these occur, contact your doctor immediately. The needle cover on the pre-filled syringe contains dry natural rubber. Before you start injections, tell your doctor if you have an allergy to rubber or latex.
Blood disorders: Rarely, people taking this medication have become deficient in certain types of blood cells. If you notice signs of infection (such as fever, shaking or chills, fast heartbeat, or quick breathing) or bleeding (such as easy bruising, blood in the stools, black tarry stools, or vomiting blood or material that looks like coffee grounds), seek immediate medical attention.
Cancer: Compared to the general population, people taking adalimumab have a slightly greater risk of developing a cancer of the immune system (known as lymphoma). However, the risk is still small. In general, people with severe rheumatoid arthritis who take medications that suppress the immune system over long periods of time may also have a higher risk of developing lymphoma, even if they don't take adalimumab. If you experience any of the following or other unusual symptoms, contact your doctor immediately:
  • chills
  • decreased appetite
  • fever
  • night sweats
  • one or more enlarged lymph node
  • unusual fatigue
  • weight loss
Signs and symptoms of lymphoma can vary depending on the extent of the disease and the parts of the body involved (e.g., chest, abdomen or bowel).
Heart failure: Adalimumab may cause congestive heart failure (CHF) or worsen existing CHF. People with CHF should be monitored closely by their doctors. Symptoms to watch out for include swelling of the feet and ankles and shortness of breath. If you notice these symptoms, contact your doctor immediately.
Infections: This medication, or other TNF blockers, can increase the risk of developing infections such as tuberculosis and those caused by bacteria and fungi. If you notice signs of an infection such as fever, chills, pain, swelling, or pus, contact your doctor as soon as possible. Tell your doctor if you have a history of infections that keep coming back, or other conditions that might increase your risk of infections, including fungal infections. This medication should not be used in combination with anakinra, as this can increase the risk of severe infections.
Immune system disorders: Some people who take this medication have developed lupus-like syndrome, an autoimmune disease (a condition where the body is attacked by its own immune system). Symptoms of lupus-like syndrome include chest pain, joint pain, difficulty breathing, and a skin rash (usually on the cheeks and arms) that is sensitive to the sun. If you develop these symptoms, contact your doctor as soon as possible.
Liver problems: Very rarely, people taking adalimumab may experience liver problems. Symptoms of liver problems include:
  • abdominal pain
  • dark urine
  • fatigue
  • loss of appetite
  • yellow eyes or skin
If you notice these symptoms, contact your doctor immediately. People infected with hepatitis B (an infection that can damage the liver) may have a relapse of their condition while taking this medication. If you are at risk for hepatitis B, your doctor may want to test you for this infection before starting treatment with adalimumab, and will follow your condition closely while you are taking the medication. If you notice symptoms of a liver problem (see above), contact your doctor immediately.
Nervous system diseases: Rare cases of disorders that affect the nervous system have been reported by people taking adalimumab or other TNF blockers. If you are experiencing numbness and tingling, vision problems, weakness in your legs, and dizziness, contact your doctor immediately.
Pregnancy: This medication is not recommended for use during pregnancy. This medication should not be used during pregnancy unless the benefits outweigh the risks.
Breast-feeding: It is not known if adalimumab passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using this medication has not been established for children.

November 07, 2008

Switching from Enbrel to Humira

I went and saw my Rheumatologist on Monday. My mobility was reassessed, and although my lateral range of motion has improved over the years, my forward range of motion has worsened. I suspected this was the case because it's been getting harder to don my socks and shoes bending forward. I've also been awoken by lower back pain every night. My Rheumatologist recommended trying Humira to see if my AS is more responsive to that medication.

Within two days, a Registered Nurse Case Manager responsible for my Rheumatologist's Humira's patients, contacted me at home, explained her role and what to expect: a call from a Reimbursement Specialist, a welcome kit in the mail that includes a sharps container, and to be connected with their pharmacy who will deliver Humira to either my home or workplace. I felt reassured to know that I had a local Case Manager whom I could contact with any questions or issues. Anyone who contacted me regarding my experience with Enbrel was always from the United States. I am uncertain of Humira's cost, but my Case Manager indicated that it was comparable to Enbrel.

Racing Accomplishments

  • 2002 Nov--Run For Life 10K
  • 2002 Oct--Canadian International Marathon 5K
  • 2002 Sept--Community Power Challenge 5K
  • 2003 Oct--Canadian International Marathon 21.1K
  • 2003 Sept--Longboat Toronto Island 10K
  • 2004 May--Ottawa National Capital Race 21.1K
  • 2004 Oct--Toronto International Marathon 21.1K
  • 2004 Sept--Scotiabank Waterfront Marathon 21.1K
  • 2006 April--London Spring Run Off 10K
  • 2006 Aug--Midsummer's Night Run 15K
  • 2006 Dec--Honolulu Marathon 42.2K
  • 2006 July--5 Peaks Durham Regional Forest 5K
  • 2006 June--Race the Lake 10K
  • 2006 Oct--Vulture Bait Ultra Trail 10K
  • 2006 Sept--Scotiabank Waterfront Marathon 21.1K
  • 2007 March--Around the Bay 30K
  • 2007 April--Harry's Spring Run Off 8K
  • 2007 May--SportingLife 10K
  • 2007 Oct--Toronto International Marathon 21.1K
  • 2008 May--Ottawa National Capital Race 21.1K
  • 2008 Aug--Iroquois Trail Test 32K
  • 2008 Sept--Scotiabank Waterfront Marathon 21.1K
  • 2008 Oct--Run for the Toad 50K
  • 2008 Oct--Toronto Zoo Run 10K