Symptom too early/mild for biologic treatment ?
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[color=black]Hi Everyone,[/color] [color=black]I’m a 35 male that started experience lot of fatigue and gastro-intestinal symptom since the last 10 year. In the last 2 year pain in the articulation has been added to the symptom and that pain is growing mostly located in the hand, back and foot. Writing is now painful.[/color] I had some test that came back positive like an echography of my wrist showing mild synovitis and a bone scintigraphy showing mild plantar fasciitis. All other test are normal, ccp, crp, sedimentation, hla b27, RA.I did a MRI that show that I also have a disc hernia in S1L5, no sign of spondiarthritis… yet. I do also have some psoriasis. They also found some inflammation in the ileum (intestine) My rheumatologist is not sure what to do. I do suffer from severe fatigue and some mornings are really are but not all morning. It can also happen from time to time that pain awake me in the night. Symptom seems to worsen with inactivity, junk food, alcohol etc. We tried many NSAID and all of them improve at first the pain but does not help with fatigue. Now on sulfasalamine for 1 month, all gastro-intestinal symptoms are gone but fatigue and pain have been so much worst. Doc said that since there are too few radiologic finding, biologic treatment is not what we should do.
1 like, 3 replies
lyn1951 ericcontant
Posted
Rheumo is correct, bioligical are an last treatment when nothing else is working.
As soon as you said you have psorasis, same as me, if we are the same you have negative Ra, is more likely to be psorasis arthiritis, yes there is such a beast, although Dr's seem not to have heard of it.
My regiem, went though sulfaslamine, my system does not like it, very high bloods pressure, itchy skin, extremely sweaty especailly at night, generally felling yuk.
I have now been on methotrextrate or MTX for 12 years now, considered gold standard, rheumo's words not mine, keeps me at a happy medium, and out of a wheelchair.
Both hips replaced due to damage, and family history of OA, big help to not have constant pain coming from hips.
Monthly blood tests to check that liver is coping.
Started with tablets, very low dose 5mg, and am now on 35mg by injection once a week for tablets and injection form., tablets not working for me, rheumo could not understand why I was getting no help from MTX, almost none in system via stomach or tablets.
Am also on leflunomide, works wonders for my arthiritis, but 20mg dose nearly killed me, extremely high blood pressure, 10mg dose I can tolerate and it does help.
Also take 6000mg of odourless fish oil capsules a day, 2 for breakfast, 2 for lunch, and 2 for dinner, with food, again helps when mixed with food, otherwise get nasty reflux.
Their are a few of us on this forum who have PA, and we do try to help each other.
ericcontant lyn1951
Posted
He wants me to start MTX if sulfasalazine doesn’t work, we will see. For now it doesn’t seems to work but I’ve been trying it for the last month, need 3 month to make sure.
Other than the joint aching I wonder if the MTX will help with fatigue
lyn1951 ericcontant
Posted
No I don't think MTX helps with fatique, in fact t only makes me worse for about 24 hours, then I start to get results with less pain, less swelling in fingers, thats where it is worst for me, hands, wrists and fingers.
Fat sausage fingers are a symptom of PA, not for everybody though.
I take a multi vitamin as well as folic acid which is a requirement after MTX anyway, replaces the B vitamins that the MTX wipes out.
My ESR and CRP are usually ESR about 45, and CRP somewhere in the 20's, neither of those readings are anywhere in the normal range, and have had ESR up in the 70's, in alot of pain when its that high.
I try to stay active as much as I can, treading water at the local heated pool, very good for all my joints, non-weight bearing in the water, also have a yearly appt with physio for checkup, we go through range of motion, which isn't great and strength, again which is very good in some joints and terrible in other joints, and she gives me exercises to do, but generally tells me I am in pretty good shape and stronger than she expected, I was crippled prior to hip reaplcements, as the specilaist said when he saw me, what was your GP thinking leaving you to get to this level of deteriotaion, before referring you, fire him, but thats another story, I was past urgent, on the point of hip and pelvis falling apart completly, the joints were dust, fell apart during surgery, first thing he asked any steps in your house, if so don't use them.
Also try to keep my weight under control, finding a really good dietian is a must.