"FDA Orders Stronger Warnings for 4 Arth. Drugs" | Arthritis Information

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http://news.yahoo.com/s/ap/20080904/ap_on_he_me/fda_arthritis_drugs

I think the news here is not the risk of infection, but that doctors have been missing this one:

"The agency said Thursday it has received 240 reports of one such type of infection, called histoplasmosis. In at least 21 of the cases, doctors didn't initially recognize the problem, and 12 of the patients died."
Suzanne2008-09-04 09:55:52I've posted about this before.  Here is a Histoplasmosis Fact Sheet.

 

It is important to note:

Histoplasmosis is an infectious disease caused by inhaling spores of a fungus called Histoplasma capsulatum. Histoplasmosis is not contagious; it cannot be transmitted from an infected person or animal to someone else.

 

Below is a partial list of occupations and hobbies with risks for exposure to H. capsulatum spores. Appropriate exposure precautions should be taken by these people and others whenever contaminated soil, bat droppings, or bird manure are disturbed.

http://www.cdc.gov/niosh/97146eng.html

Suzanne-
 
Interesting post.
I remember that woman who died in the RA clinical trial (gene therapy, was it?) actually had histoplasmosis and they didn't know it.  I wonder how she was exposed - roofing?  spelunking?  restoring an abandoned building?   http://www.pharmalot.com/2008/09/fda-wants-tougher-warnings-on-tnf-inhibitors/

Pharmalot says what I was saying!:

"Since the initial approval of the four TNF blockers, the FDA notes the prescribing info has included info about the risk of serious infections, including fungal infections. However, based on reports reviewed by FDA, the agency says health care professionals are not consistently recognizing cases of histoplasmosis and other invasive fungal infections, leading to delays in treatment." Suzanne2008-09-04 10:36:31[QUOTE=Suzanne]I remember that woman who died in the RA clinical trial (gene therapy, was it?) actually had histoplasmosis and they didn't know it.  I wonder how she was exposed - roofing?  spelunking?  restoring an abandoned building?   [/QUOTE]
 
As I remember,she lived in a farming community...
Suzanne,
 
What do you expect? They are just stupid Doctors. It's because of stupid Doctors (Real Doctors) that so many of us die and are crippled and deformed and not mobile or able to function. If the people with RA would just wise up and listen to the Fake Doctors (the ones that think they are smarter than Real Doctors)  that are members here at the arthritis insight forum, we wouldn't have to worry about disease or dying or warnings and life would be beautiful.
 
But since most of us are stupid as our doctors, we better always remember that our immune systems have been suppressed and that at the slightest sign of infection or sickness we must take immediate action, doctor call at least or urgent care visit.
 
LEV
[QUOTE=levlarry] Nikkilynn - Histoplasmosis - wasn't that the thing in MI?  Something about a convo with you, me and Linncn?
 
Pip
Yep....................If fever is the most common sign of infection and our medications suppress a fever then what are the other most common warning signs of infections? No doubt I could look this up but I've only been able to pop in and out this afternoon. No time to actually search out answers. Figured you guys have a quick answer to that.
 
I never run a fever. My GP claims it's due to my medications. I guess it's true.
Just a little more info.......

 

Histoplasma capsulatum is primarily found in the temperate regions of the world and is the most common fungus in the United States. It's endemic in the Ohio, Missouri and Mississippi river valleys, where the great majority of people have been exposed.

The fungus thrives in damp soil that's rich in organic material, especially the droppings from birds and bats. For that reason, it's particularly common in chicken and pigeon coops, old barns, caves and parks.

Birds themselves aren't infected with histoplasmosis — their body temperature is too high — but they can carry H. capsulatum on their feathers, and their droppings support the growth of the fungus. Birds commonly kept as pets, such as canaries and parakeets, aren't affected. And although bats, which have a lower body temperature, can be infected, you can't get histoplasmosis from a bat or from another person.

Instead, you develop histoplasmosis when you inhale the reproductive cells (spores) of the fungus. The spores are extremely light and float into the air when dirt or other contaminated material is disturbed. That's why a high number of cases occur in farmers, landscapers, construction workers, spelunkers and people living near construction sites.

 

http://www.mayoclinic.com/health/histoplasmosis/DS00517/DSECTION=causes

This is from the CDC
http://www.cdc.gov/nczved/dfbmd/disease_listing/histoplasmosis_gi.html

"Can anyone get histoplasmosis?

Yes. Positive histoplasmin skin tests occur in as many as 80% of the people living in areas where H. capsulatum is common, such as the eastern and central United States. Infants, young children, and older persons, in particular those with chronic lung disease are at increased risk for severe disease. Disseminated disease is more frequently seen in people with cancer, AIDS or other forms of immunosuppression."


Suzanne2008-09-04 16:53:08TTT

Anna - why are you moving these to the top?  I agreed with you?

Confused?
 
Pip
What I find most disturbing about this is the majority of these cases of histoplasmosis---over 200 of the 240---happened to people on Remicade, yet the phama company only reported 2 of them. Why isn't there more concern or downright outrage that the company would misrepresent the number so vastly. It stands to reason they may be suppressing other information as well.

[QUOTE=Gimpy-a-gogo]What I find most disturbing about this is the majority of these cases of histoplasmosis---over 200 of the 240---happened to people on Remicade, yet the phama company only reported 2 of them. Why isn't there more concern or downright outrage that the company would misrepresent the number so vastly. It stands to reason they may be suppressing other information as well.

[/QUOTE]

My feeling is that we will find out something similar when it comes to the actual number of cancers in children/young adults on the anti-TNFs.

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