Question
I have advanced psoriatic spondylitis. Enbrel has kept it under control for the past three years but I still have debilitating flares a few times a year. I can’t take prednisone anymore because trying to get off the drug now always throws me into a worse flare than what I started with. I can’t take methotrexate or sulfasalazine because my body doesn’t respond to them anymore – I’ve failed them as the doctors like to tell me. As I was reading about Kineret and Orencia I got the bright idea of trying one of them in addition to my Enbrel to try to stop a flare since they are not TNF alpha inhibitors. I am on disability and could play hermit during the trial – I can’t get out much when a flare has me down anyway – to help with any concerns of lowered resistance to infection. My immune system is so overactive I’ve never experienced the problem before anyway. Do you think combining Enbrel and Kineret or Orencia might help stop a flare?
Answer
Enbrel or the other TNF inhibitors (Humira and Remicade) should NOT be used with Kineret or Orencia because of side effects. The combinations were formally studied in a clinical trials and more infections and low blood counts were seen with Orencia and Kineret repectively.
