All posts filed under: Drugs

The core treatment for RA is an arsenal of drugs

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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 …

Four years of RA

  I was diagnosed with RA four years ago, this month. The first few years were whirlwinds as I was also diagnosed with two cancers that each involved surgery and radiation treatments.  My RA moved to the back seat then to the front and again back and forth. Now it is center stage.   In 2015, I was started on infusions of Orencia. Once I realized that the biologics only help your RA by about 50%, I settled in and appreciated that they helped that much. In July the next year, I developed a horrific flu. I haven’t had a flu for years. It was exhausting. Plus, the Orencia was not working any more. I started having bad flares. My rheumatologist stopped the Orencia. After a few weeks, I was started on infusions of Remicade, a TNF inhibitor. By the third loading dose, I was having a severe flare plus I was having a bad reaction to the Remicade. I was ill. It took two months for the Remicade to clear my system and for …

Rituxan- the final frontier

Rituxan, the final frontier February marked the second anniversary of my Rheumatoid Arthritis diagnosis. After two years of treatment, my average pain level was reduced from 10+ to an average range of 4 to 7 every single day.  The constant presence of pain and a body riddled with inflammation continue to suck every drop of energy from my aging, aching body. My treatment was complicated by the addition of thyroid cancer and soon after that with the addition of  breast cancer. Both required surgery. Both required radiation treatment. Both required medication.  Both interfered with my RA treatment. The TNF antagonists, like Embril, are contraindicated for those who have recently had cancer. I am not allowed to have them. The ongoing treatment for thyroid cancer is to keep my body slightly hypothyroid. It helps prevent the cancer from recurring but it also increases the effects of RA fatigue. The ongoing treatment for breast cancer is anastrosole. It eliminates all estrogen in the body. It also puts me at high risk for osteoporosis as does Rheumatoid Arthritis. My treatment originally started with …