All posts filed under: Treatment

All the medical services that help treat rheumatoid arthritis

More about RA drug Actemra

Response to expect  with Actemra                                                                                     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.

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 …

On becoming the bionic woman

I wonder how many of us are walking around with replacement parts. Joint replacement has become common and it is successful surgery. I have several friends who have both knees replaced or both hips replaced and they are fine with it. And now, I am about ready to embark on my first joint replacement. My left hip will be first on the chopping block. This is a bad visualization. I am trying hard not to think about what the surgeon will be doing. It is scary and gruesome. A Frankenstein thing. Instead, I am focusing on the bionic woman thought. I will be in much better condition once I complete the rehab process. I will have a fabulous new joint. Won’t I be lucky? I will. I have spent the summer in extreme pain. My doc had a tough time identifying my hip issue. After all, my hip had good range of motion without pain. An MRI revealed my hip deteriorating badly plus a bad labral tear with pieces loose in the joint. My pain …

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 …

Remicade

My treatment for rheumatoid arthritis, RA, is moving in the opposite direction of normal. Because I was diagnosed with two cancers and rheumatoid arthritis in the same year, the wonder drug biologics were off limits for me. They presented a higher cancer risk. Eventually as my RA worsened, quality of life became a factor. Methotrexate(MTX) injections help, but not enough. I had tried the triple treatment of MTX, Plaquenil and sulfasalazine without success. Leflunomide was next, but it didn’t work either. The small molecule DMARDs were exhausted as treatments.  The biologics were next. Rituxan was considered the safest both by my rheumatologist and by my oncologist. I was infused with Rituxan. It didn’t work. Next safest was Orencia. I was infused with Orencia. It helped. It helped about 50% which was the norm for it. I received monthly infusions. But my flares became much worse at 10-11 months. Orencia was stopped. Next is Remicade. Remicade, infliximab, was approved for RA in 1999. It is a TNF inhibitor. My rheumatologist had a serious discussion with me …

What does ACR20 mean

    Have you ever thought about what the numbers mean when they say 50% ACR20 at 6 months? This simply says 50% of the group had a 20% response at 6 months. It means half improved by 20%.   The ACR improvement criteria includes ACR20, ACR50 and ACR70. Meaning, 20%, 50% and 70% improvement. Easily enough to understand. I was reviewing a research paper on Orencia. I will be having my 8th infusion on Thursday. I was wondering if it was being effective enough and if I should keep taking it. The article had a chart for clinical responses in controlled trials. I reviewed the column that said inadequate response to methotrexate (The reason for being on Orencia; I think my methotrexate response is 50%, but it is not enough for me.) A response of ACR20 3  months 62% 6  months 68% 12 months 73%   This means that at 3 months 62% of the patients had a 20% improvement This means that at 6 months 68% of the patients had a 20% improvement. …

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 …