Biologics and TB | Arthritis Information

Hello,

I am not new here but have been gone for sometime. I was DX'd with RA about 2 years ago and have not been able to control the inflammation. So my Rheumy decided that I needed to go on Enbrel, (which scares me a little bit) to see if they can bring my RA under control. I had a positive re-action to a PPD test but do not have TB. So the Pulmonologist said that they are going to OK the Enbrel but that I should take the medications for the TB, just to be on the safe side. They are going to remove my Methotrexate as soon as I start the Enbrel and then ween me off the Azulfidine, leaving me on the Placquenil w/the Enbrel.

My question is....Has anyone had this happen to them and if so, how did they handle your case?

Thanks for any insight you can give me on this matter.
Waddles

Same here with me, postive test (they told me I might be allergic to the stuff in the test) but no TB. I have to take Isoniazid, 300mg + Pyridoxine HCL 250 mg. Here is Canada they do this a lot with enbrel/humira. The doctors say they just don't know enough to take the risk. I started the extra meds in October and finish at the end of July. It's not a big deal to have the peace of mind. Yes, I tested positive for TB before starting Remicade. Positive for TB exposure not active TB verified by an XRAY. They should verify with XRAY!! The reason for the TB test now is because they started giving people biologics who had been TB exposed. The dormant disease was activated and they died!!!

Maybe I just read your post wrong, though. I wish you the best.

Sara38517.8033101852

Sara, correct! She should NOT take Enbrel until the medicene for TB exposure has been taken for 9 months! And even then I would ask about the risks! My Rheumy will not EVER let me take them! It CAN activate THE dormant TB germ in your lungs!

NOTE; THEY THINK I GOT EXPOSED to TB WHILE ON MTX!!

KarenNTx38517.8638541667Good Morning Everyone,

Thank you so much for your replies. This recent decision on taking the Enbrel and TB meds, together, has been very trying for me. That is why I came to you all, to find out as much information as I could before I oK'd any new meds, especially when faced with such possible bad outcomes.

I have been all over the Internet and most of the sites that I have visited, stated that you should take the TB meds. first then take the Enbrel. Which makes a lot of sense to me.   As for my doctors reasoning on this subject, I don't know and I am not quite sure what has them convinced I can do the 2 together and not have a bad outcome.

Here is the storyline>>>My RA, has yet to show any signs of a slowing or stopping of inflammation. My RA doctor has tried different concoctions of meds and still no real improvement ( constantly up and down with the inflammation).   So she decided that it may be time to try Enbrel. Had the Chest xrays done (past +PPD) showed signs of scarring, so had a cat scan done. They went over my past chest xrays and cat scans and decided that the lung scarring came from my BC radiation...Another PPD test was ordered, in which I had a reaction...Waiting for the results to come back from Sputum samples...If those results come back negative, my Pulmonologist has ok'd the use of Enbrel with the TB meds and removing the Methotrexate.<<<

RMaria,
Did you take the Enbrel after taking the TB meds?

KarenNTx,
So, your doctors thought that you may have been exposed to TB while taking Methotrexate or that your reaction to the PPD test could have shown positive from taking Methotrexte?

Thank you all for your thoughts. I appreciate the time that you all have taken to help me through this problem...I sure feel better knowing that I am not the only one with this problem. But I would feel much better if we all where not in this situation to have these problems.

Have a wonderful day Ladies and I am looking forward to spending more time with you all.

(((HUGS)))

Waddles

This disease is sure to make us all NUTZ!...LOL.

wADDLES, THE MTX DID NOT CAUSE A POSITIVE TB TEST! YOU ARE UNDER A RHEUMY'S CARE, NOT MD, RIGHT?    THEY THINK I WAS EXPOSED TO TB WHILE ON MTX BUT NO WAY TO TELL FOR SURE. YOU ARE MORE SUSEPTIBLE TO MAJOR ILLNESS WHILE ON MTX, THAT'S WHAT RHEUMY SAID. YOUR DOC IS THE BOSS. I JUST WORRY ABOUT YOU. DID THEY GIVE YOU AN XRAY TO MAKE SURE THE TB IS NOT ACTIVE? EXPRESS YOUR CONCERN ABOUT TAKING A BIOLOGIC BEFORE THE TB BUG IS TREATED.   THE TB BUG, IF YOU HAVE BEEN EXPOSED IS IN YOUR LUNGS....DORMANT.   BIOLOGICS HAVE BEEN PROVEN TO ACTIVATE TB!!!!   THAT'S THE DANGER!!! YOU CAN HIGHLIGHT IT ON THE BIOLOGIC WARNING SHEET AND SHOW HIM! PLEASE LET ME KNOW WHAT HE/SHE SAYS AND HOW YOU'RE DOING DEAR! TAKE GOOD CARE AND STAY IN TOUCH! I AM ON MY LAST WEEK OF INH FOR TB EXPOSURE. (9 L O N G MONTHS) HUGS!!!!!

Sorry it's taken me awhile to get back with you. Got a chance to go out of town and I went. Had a great time, came back relaxed, which is something I haven't felt for the past 4 years.

I wanted to tell you that I got a hold of an RN that works for Enbrel and she informed me, that yes, that while they did have incidences of TB occurring with people who had been exposed to TB by someone who had active TB but that the numbers where low and as long as we are treated with Antimicrobials prior to starting on the TNF inhibitors, according to the official TB screening guidelines, the patients risk of TB virtually disappears. That helped me feel somewhat better about starting Enbrel but like any medicines, there is always going to be some risk.

I noticed that you are using Sulfasaldine. Has this med. helped you? I am on it and have been for sometime and it doesn't seem to help me at all. I'll be glad when I go off this drug, plus I don't like having to worry about sun sensitivity while taking this medication... I am an outdoors girl from the get go. They added Placquenil to my cocktail mix but I think it may be to early to tell how it may be working. I also take Tramadol but then again, I feel it's another med. that doesn't have much of a kick to it, so I don't use it very often. I like to see how you are going to do with the Nabumetone, if it seems to work for you, I may ask about that drug, when I see my RA doctor in July. God I remember when I rarely took any medications and now (4 years later ) I have to buy an extra medicine cabinet, to hold all my meds...LOL...

I hope you and everyone else on this board have a Great day and find that inner peace we all our looking for.

Take care,

Waddles

OPPS, Sorry about the misspelled words. Seems my Spell Checker didn't catch them all....