All posts filed under: Drugs

The core treatment for RA is an arsenal of drugs

At the infusion center

I am taking a big chance. I went to the infusion center for a dose of Actemra. Actemra blocks the activity of the messenger cytokine, Interleukin-6. It was the  same routine: sign in at the reception desk, weight, vital signs, 20 questions. I am in a recliner with my feet up. IV started. Blood work. Tylenol and Benadryl to avoid side effects. I think this was the routine for all my infusions. My son, David, was with me. The Actemra infused without incident. I didn’t die. We were there for three hours. I had mixed feelings about this drug. It stemmed from several considerations. I have had a lot of bad luck with the biologics. The last was the TNFi Remicade. After two doses I became so ill I thought it was over. I felt weak and lethargic. No appetite. It lasted a month and I survived. I was reluctant to try another. Actemra was the last one available to me.  My RA Doc feels the drug is safer than no drug because the progression …

Actemra as a possibility for My RA

My journey through the biologic DMARDs  began with infusions of Rituxan. I had no relief from my RA with Rituxan. Next in line were infusions of Orencia. Orencia gave me about 20% relief. At the time it was better than nothing. Orencia worked for over nine months and then stopped working. At the time I had a worse than normal flare and developed a horrible flu. Up to that point I hadn’t had a cold or a sinus infection for 3 years. After about six weeks I was started on infusions of Remicade. Remicade has three loading doses scheduled 2 weeks apart. I completed the loading doses and then became terribly ill. I felt like I was in ‘a failure to thrive’ situation. Absolutely no energy, listless is a good word. I moved into a bad flare which overshadowed the side effects of the Remicade. I was in a bad way for over a month. Remicade is a TNF inhibitor (TNFi). The recommended suggestion is that if a TNFi is stopped because it doesn’t work, another TNFi …

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?