All posts filed under: Drugs

The core treatment for RA is an arsenal of drugs

Seven year anniversary and infection

It was seven years ago this month. I was acutely ill with my first encounter of rheumatoid arthritis. My illness had not been given a name yet. A week before that I had seen the ER doc who started me on prednisone and who was  sending me to the rheumatologist that I would see in about another week. I had very little sleep. A few hours a night at most. I was in excruciating pain. Life was not good. I can look back with a sense of relief. I no longer have the kind of pain that made me think I had broken glass shards in my joints. It took several years after my diagnosis for my RA to settle down. I never went into remission. My inflammation has always simmered. Methotrexate was my base. I finally settled into 25 mg subq once a week. It helped. After a few years my pain was never quite the same as it was originally. My feet became central to my discomfort. Custom orthotics and Dr Comfort shoes …

Infection and off methotrexate

I stopped taking Actemra. I had only two doses this time. Last week I stopped taking methotrexate. I had been on it since 2013. All this was at  a suggestion from my oncologist who was helping me battle a severe breast infection. The infection started in October 2019. I went to a wound clinic for a month. I had surgery to debride necrotic, radiated breast tissue 13 December. Then the infection returned. Perhaps it had never left. I also developed a severe cellulitis. The cellulitis covered my entire breast or what was left of it. Now the cellulitis is down to a couple of inches. The whole thing was caused by  the radiation treatment that I had for breast cancer in 2013. The radiated tissue became necrotic and infected. It is not uncommon. I wonder what part my RA drugs played in this long standing dilemma. This infection has gone on for three months. I do know that methotrexate should be stopped while a person is on an antibiotic. Methotrexate should not be used at …

Mary Man's RA Journal Icon

Understand your RA risk

Journal, November 2, 2019 Drug choices I have written my last few articles on the subject of RA biologic drugs. Why? For several reasons. I am finally starting to do housekeeping on my web site. Long overdue. I have a plan to make my site a place for useful, easy to find information on the autoimmune disease, rheumatoid arthritis. I have some good articles already, but I also have a bit of clutter. My new articles begin with the drugs that will affect the progression of rheumatoid arthritis. I chose Actemra because I am currently on it. Before I started the year long treatment for my last cancer, I had started Actemra infusions. The drug was working but was stopped because of surgery, chemo and radiation. I am now on the Actemra subcutaneously with the prefilled syringe. I take my second dose today. It is an easy process. I believe it will work. I chose Orencia as the subject for another  article because I had written a number of posts while I was taking the …

My Journey with Orencia

I published this series of posts during the year I was on Orencia. The following are my experiences. August 2015-August 2016 Tomorrow I have my first infusion of Orencia. It is a biologic used to relieve symptoms and slow the joint destruction of Rheumatoid Arthritis. I have just read the medical insert for Orencia. The studies are hopeful. (Having statistics in college finally pays off. The infusion  will take 30 minutes. My son is going with me. He is good company and a morale booster. In two weeks I will have another infusion. At one month I will start infusions monthly. I will be happy to have the infusions as long as they help. I have read endless online comments of those who have taken Orencia. They have met with success for the most part. Success means less pain, less disability. It means more energy. It means more life. Orencia , after three months I knew Orencia was working for me one week after my first infusion. Swelling in my hands, ankles and feet gradually …

More About RA Drug Orencia

Orencia Abatacept Abatacept, trade name Orencia,  is a biologic medication for rheumatoid arthritis. Ads for it have been on tv.  It reduces the inflammation that causes some of the symptoms of RA. It is also used for adult psoriatic arthritis and juvenile idiopathic arthritis. Response to expect                                                                                                                     According to clinical trials of Orencia use, up to 75% of patients had a 20% improvement at six months . About 50% had up to a 50% improvement. About 13% had a 75% improvement. In these studies, methotrexate was also being given. Pill, shot or IV?                                                    …

More about RA drug Actemra

Actemra     Tocilizumab     TCZ Actemra is a biologic drug used to treat the symptoms of rheumatoid arthritis. It is also approved for giant cell arteritis, polyarticular juvenile idiopathic arthritis (PJIA), systemic juvenile idiopathic arthritis (SJIA) and cytokine release syndrome (CRS). Response to expect                                                                                                                              At 24 weeks of weekly injections, 69% of those with RA had a 20% improvement in  symptoms. Additionally, 47% had a 50% improvement and 24% had a 70% improvement. That leaves 31% with no improvement. None of the biologics work for everyone. Pill, shot or IV? Actemra is a rheumatoid arthritis drug that is a large molecule. What that means is that Actemra would not work as a pill and must …

Plaquenil and the eye

I have a question about the drug, Plaquenil, AKA hydroxychloroquine. My interest stems from the book I am writing, Nurse Mary’s Guide to Rheumatoid Arthritis. After reading several additional medical reports about Plaquenil, I realized I needed to look further and to expand its section in the medication chapter of my book. Another reason for my interest was that I had been taking Plaquenil for six years for my RA.  I was taking it in addition to methotrexate injections and Medrol. I had  also been taking it while I was taking tamoxifen for breast cancer. I no longer take tamoxifen as I developed a rare serous uterine cancer associated with using the drug. None of my doctors questioned the risk involved in taking both drugs. I also made the mistake in thinking Plaquenil was a mild drug. In fact, it does treat mild RA and more aggressive RA when given in combination with other drugs. The drug itself is not mild. Hydroxychloroquine  was developed as an antimalarial in 1955. It was a refined version with …

I thought I was going bald, it was just the MTX

About six weeks ago, I started noticing my hair thinning. I thought it was odd because my dad had thick hair in his older years. I expected my hair would do the same. My hairdresser also noticed the thinning. It was real. Next, I started noticing bunches of hair on my comb. “My hair is falling out,” I thought. Right again. I quickly realized that it was the methotrexate (MTX). Hair loss only occurs in 1-3% of those on MTX. I have been on it for five years and the last three years I have been giving myself 25mg injections. It works for me. I am also on hydroxychloroquine (Plaquenil). Plaquenil can also cause hair loss. I started taking MTX every eight days instead of every seven. Every nine days starts an RA flare. I stick with the eight days. I also cut the Plaquenil to 200 mg daily from 400 mg daily. My hair is no longer falling out. However, my hair hasn’t grown since my last haircut. Unfortunately, it was the second worst …

Methotrexate NSAID or DMARD ?

I can now count myself  as one of the few who has read the package insert for methotrexate. I am researching RA drugs for my book.  I give myself injections of 25mg methotrexate weekly. I was opening a new box and preparing to give myself an injection.  Impulsively, I decided to read the insert. Methotrexate has become the gold  standard for RA treatment. It has been one of the few drugs to help relieve my symptoms. Imagine my surprise when I read the following. Medication guide insert with boxed  methotrexate; “Although methotrexate clearly ameliorates symptoms of inflammation (pain, swelling, stiffness), there is no evidence that it induces remission of rheumatoid arthritis nor has a beneficial effect been demonstrated on bone erosions and other radiologic changes which result in impaired joint use, functional disability, and deformity.” So since it doesn’t stop RA progression how can it be classified as a DMARD, Disease Modifying Anti Rheumatic Drug?  Shouldn’t it be a NSAID,  Non-Steroidal Anti-Inflammatory Drug?

RA, Biologic Medication and the numbers

Reading the fine print on a medication insert is not done by many of those with RA. I suspect the big reason is the amount of time it would take to understand all the information or even to understand the information of value to you. It does seem like too much work. But there is a time to buckle down and read the inserts. I am at that time. I need to make new decisions with my Rheumatoid Arthritis(RA) treatment. I have tried three of the biologics. One didn’t work. One worked about 50% for nine months and then left me to a bad flu and a worse flare. The third just made me sick. I felt like my life was being sucked out of me. It was not a good feeling to have. For the last six months, I have sustained myself with methotrexate injections coupled with hydroxychloroquine, meloxicam and methylprednisolone. I love methylprednisolone (Medrol). It makes me feel better. I morph from a cripple in excruciating pain into someone feeling almost well. My …