opinions on choosing Cosentyx OR Humira (possibly with MTX in a blind study)

[artemie]

hi members,

Trying to make my mind up and would really appreciate your input / experiences. Humira, possibly with MTX or Cosentyx.

I'm new, see 'intro ArteMie"  in the right place. PASI 11.5 so eligible for biologicals. Tried UVB (doesn't work anymore...), dymethilfumerate (enteric coated, slow release, still horrible tummy pains.. ) and lots of creams. 

Been to an academic hospital and had bloodwork done. if the results are positive I can choose: 
- partake in study; Humira in combination with a low dose of MTX. 50% of partakers get MTX, the other half only Humira. Computer chooses.
- go for Cosentyx.

I hear good things about Cosentyx. Some nightmare stories but mostly good. The hospital says I can have it but they're slightly reluctant because the medicine is still relatively new; no long term data on side effects.

Whats your view / experience? Would be great to have some input to help me make a choice.

   ArteMie

[Turnedlight]

Hopefully if one doesn't work you should get to try others anyway.. though of course a different system to uk.

[Fred]

I'm a big fan of the Bio's as they gave me back my life. I hate Methotrexate as it ruined my life, so for me it's a no-brainer.

Humira is a good treatment, but knowing you may get methotrexate instead would put me off the trial.

I can understand the issue with Cosentyx, but for me personally it's the best Bio I have ever tried.

I wonder as they are talking about Bio's with you if it would be possible to try another Bio? Enbrel is similar to Humira, and Stelara is similar to Cosentyx.

If it was me making your choice knowing what I know from my own experience I would ask to try Stelara and see how you get on with Bio treatments.

If you use the Search (only available to logged-in members) you may be able to narrow down your options, but I'm sure others will chime in with answers.

[Caroline]

What I found in a recent interview with a researcher in Erasmus MC, who does research is the following.

Basically there are two Interleukins involved in Psoriasis IL-23 and IL-17 , there are more involved, but lets not make it too complex, otherwise I don't understand it anymore.
It appears that IL-23 is more connected to Psoriasis and IL-17 is more connected to Psoriatic Arthritis (PsA)

Looking at Stelara, this is more an IL-23 inhibitor, it blocks the pathway it is said, and
Cosentyx is an IL-17 inhibitor.
If you would use plain Farmers logics, medics can do different reasoning, then if you have P, you should aim for Stelara, if you have PsA you shout aim for Cosentyx.
Btw, Psorinovo (DMF) moderates both IL-23 and IL-17 (and more) so that is why it works for P and PsA, although some medics will state different, basically they don't have the experience but theoretical knowledge.

Another interview, with a dermatologist of the AMC Amsterdam, shows that in a comparison between Enbrel (etanercept) and Remicade (infliximab), the Enbrel is certainly working nicely AND.... does not lead to the forming of anti-bodies, so this means you can stay on using it.

[Turnedlight]

So basically we should get a dose of Humira and Stelara together to hit both issues!

[artemie]

hi, 

Fred; the study is either Humira with (lower dose) MTX or Humira without it. Computer chooses random who gets what.

I can actually try all of the biologicals, not just this or Cosentyx, for some reason my brain forgot about that. Stressfull times here, brain fog.
But thanks guys, lots more to think about. Maybe I shouldn't worry so much and just see what happens, switch if not happy. By persisting and shopping 3 medical centres, I feel I earned this luxury =]

Post number 8, almost entitled to read member journals   But first, BBQ in the Dutch sun with friends. And wine.

[mataribot]

Go for cosentyx. The TNFs (Humira) stop working. They are probably trying to see if they can get you close to remission, drop the bio, and keep you disease controlled with MTX

[Caroline]

Go for cosentyx. The TNFs (Humira) stop working. They are probably trying to see if they can get you close to remission, drop the bio, and keep you disease controlled with MTX

Sensible remark Mati !

[Fred]

Go for cosentyx. The TNFs (Humira) stop working. They are probably trying to see if they can get you close to remission, drop the bio, and keep you disease controlled with MTX

[artemie]

might just put trust in the doctors and see how it goes. it certainly will save me a lot of endless googling and frying my brain 
plus there is always the option of switching.