All I Want for Christmas Is My CRP

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I thought I’d finally gotten out of Rheumatoid Arthritis / CRP purgatory, but I was wrong.

Christmas cardI got an early Christmas present after I got back from the ACR meeting, I got a certified letter from my rheum doc. It said I couldn’t have any more Actemra infusions because my insurance company would not pay properly.

It turns out it insurance companies are using a loophole related to Actemra’s “newly approved” status to reduce payment for this Biologic. So, it cost my doctor hundreds of dollars per patient per treatment.  The doc was forced to pull patients off Actemra.

My infusion was cancelled. But don’t feel bad for me. Actemra hadn’t started to help yet, anyway. Last weekend I read a testimonial from a patient who improved after the fourth Actemra infusion. That’s the one that I didn’t get.

Why would someone already diagnosed with RA need a high CRP?

What’s next? A few things… I’m learning a lot about RA clinical trials and guidelines for inclusion, like CRP levels. My CRP tested “normal” last week, which may exclude me.

Do you want to know how I feel about CRP? I feel like I’m a detective solving a crime. If CRP is the culprit, here are some incriminating facts:

  • There are genes that lower a person’s CRP. From what I read, the more of these type alleles you have, the lower your potential for CRP is. A Rheumatoid Arthritis patient can have severe inflammation with normal CRP. This recent study implores clinicians to consider this fact.
  • According to a study in 2009, CRP was normal in 44% and 58% of Rheumatoid Arthritis patients in two groups studied by Sokka and Pincus.
  • There is documentation that each of the medicines I’ve taken over the last several months and years reduces CRP levels: ibuprophen, methotrexate, prednisone, and Actemra.
  • There are several things that raise CRP that aren’t technically inflammation: smoking, high BMI or obesity, diabetes, or poor diet. I have none of these going for me.
  • I’ve never had a scary high CRP. It’s only been checked a few times in my life and I had an either normal or moderate result.

CRP has certainly implicated me as a liar in the past, so forgive me if I’m anxious to convict. I remember when Dr. Space Heater demanded I admit that a normal CRP proved my Rheumatoid Arthritis was non-existent or in remission. I’d love it if the CRP were right and I were fine, but I’m afraid I can’t lay my spear down yet.

Recommended reading:

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Kelly Young. All rights reserved.

This entry was posted on Friday, December 3rd, 2010 at 6:00 am and is filed under Don't miss this!. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

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