I was wondering if anyone had any thoughts or info about this. I was officially diagnosed 4 years ago, and have not been able to find a successful drug combo. I probabaly had it for about 15 years before I was DXed. I had flares for those years and then in the last 4 years it has been one constant flare. Do the Biologics and DMARDS work more effectively if they are started at the beginning of the disease. Is it more difficult if you have long standing disease???
I would appreciate anyone's experience or thoughts on this subject. You all are so helpful!!!!!
Thanks,
Karen
What have you tried in the past? What did your xrays show - amount of damage? I was dxd 20 years ago, got MTX 16 years ago and had used that, OTC pain relievers and occasional prescription pain relievers until Jan of this year, when I went into a terrible flare. My progression was pretty slow compared to some of the stories here. I do have a deformed middle finger, can't make much of fist and my knees are stiff, but until this flare it was all stuff I could live with. Now I'm on Remicade, 20mg MTX, 10Pred, 3Aleve. I feel better than I have in years, wasn't really listening to what my body was trying to tell me, but I have a Dr. aversion and I think most of the feeling better is because my anemia is resolving itself, but after 3 months in pain hell even the smallest improvement was a miracle. You don't say what you are taking, but everyone here seems to be on different combo's. The biologics, I tried Enbrel for 2 months first, my GP sent me to an internist, who switched me to Remicade and she's slowly upping the frequency and amt, aren't working, I think it's the Pred and will start weening myself off it, to see what the real story is. There are many options out there and 4 years of flare is an awfully long time. If I had been more aggressive about this maybe my joints would be in better shape, but I was dxd when my GP was hesitant to even prescribe MTX, I was in my child bearing years. Once the damage is done it can't be reversed, so dr's are using them sooner and I haven't heard that the combo doesn't work as well if you've had RA longer, but I would keep at my dr. to find what will work for you. I'm no longer taking Naproxin, Hydrocodone, or Oxycodone to get through the day, that's a big improvement, but I have them in the medicene cabinet.Karen, I do believe it is harder if you have longer standing disease because damage is irreversible. But you should try them any way. If something ends up working, then you are going to be far better off.
Ninilchicken, is there some reason they don't have you on Plaquenil, Celebrex or Mobic? Also, ask if they can up the MTX to 25 mg. That's about as high as they go. But I notice big difference between 20 and 25 mg. Plus, you should be under the care of a Rheumatolgist, with the Internal Medicine doctor as your primary. Rheumys are much more knowledgeable. My previous had three employees dedicated just to following the latest research on RA.
The dmards /biologics work the same but the damage that happened is still there. The bone upon bone thing can be horribly painful - it can even swell and be warm to the touch - like an RA attack. That kind of inflamation does not respond to the dmards /biologics very well. Cortisone inj and pred work on it better, I think.
Have you really been in a flare for 4 years or do you have 4-6 really badly damaged joints? It maybe time to have things surgically repaired.
p.s. I'm in that boat with you, so there are at least 2 of us.
I am taking 10 mg Pred for the last 4 years and I up it to 15 mg when I get really bad for a few days. I am going to start Kineret, I thought I would give it try since it works differently.
I took plaquinel without probs for 3 years but it stopped giving me any relief, and took MTX with out much improvement, but had to stop because of my liver function. I took Enbrel for 6 months and it helped with my energy and swelling not pain, but it caused problems with my blood not clotting so I had to stop. I tried Humira and got no improvement. So maybe Kineret will work!!!
I hope so. Let us know how it goes.
I expect that it will help with energy and swelling, but you probably will be stuck with the pain from damaged joints. Still that crabby sick icky feeling should go - leaving catches and crunches. Catches and crunches though painful are lots better than feeling sick.