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Wow! It will be interesting to see if future studies back up that small study predicting which patients will benefit from the biologics. I am lucky enough to have responded to Enbrel after MTX failed to help, although it’s certainly not a return to full function and I also need Plaquenil and an NSAID. I’m so grateful that we’ve finally got a combination that allows me some return of function. Wouldn’t it have been nice for me and my doctor both to know from the moment of diagnosis that I might be one of those who would respond? And wouldn’t it be even more important and helpful for those who won’t respond? They wouldn’t waste valuable time, losing function and enduring side effects on therapies that aren’t going to help.
Yes, it will be good when we can do that. And the urine test could be fast and cheap too – and done in a clinic, if it’s accurate.
Of course what we need are options for the other patients – new types of treatments and a new paradigm – for those who don’t respond to current treatments and have no relief.
I read the article about the urine test and the correlation – how exciting it would be to know if these drugs would work! But I noticed that the RA patients selected were all RF positive and antiCCP positive and the the PSA patients didn’t have any correlation but did respond – very confusing! So they didn’t try a correlation for RF negative RA – like me, no help there!
I do know that we do need markers. It seems to be a heterogenous disease; no patient is the same and there is no such thing as classic RA – or if there is, it is few and far between.
Hi Leslie, It was a very preliminary test to see if there is a correlation worth pursuing. I suppose that they chose people who were serum positive so they could absolutely ensure diagnosis (that they were dealing w/ RA patients) before they made any conclusion. Practically, we’ll need tests – and treatments – for each type of patient (phenotype) under the one (general) diagnosis that we now call RA.
I read further about the long term outcomes of glucocorticoid (prednisone) treatment. Specifically, I read the article “Safety of Medium to Long-term Glucocorticoid Therapy in Rheumatoid Arthritis: A Meta-analysis” by Ravindran, Rachapalli and Choy (2009) in Rheumatology, Vol 48, pp 807-811 clearly shows that there is not sufficient evidence to support the benefits of prednisone over time (2 years or longer). There is evidence for using prednisone in the initial stages of RA to control inflammation and pain. The positive effects are substantial up to 6 months after initial diagnosis. I think it is important to not mislead the RA group about long-term benefits of steroid use !!! For me, I intend to use prednisone as needed but have decided not to use it on a low dose continuous basis, as has been suggested. I’ve decided the risks outweigh the benefits and I cannot see that there is sufficient scientific evidence to convince me otherwise. I am a big fan of RA warrior and Kelly’s work !! Many many thanks…
Hi Helen. I hear your concern. And I hope disease treatment works well for you. There are a large number of people who are non-respondsers or inadequate responders and require something (pain meds, nsaids, or prednisone for example) to make it bearable or to help them keep going, depending.
Reading and doing your own research is good. I’ve read dozens of articles that discuss the various methods of steroid use for RA. More than that though, I’ve learned from hearing from thousands of patients. There is wide variety of use & response as well as side effects.
By the way, there are a few other articles here that discuss prednisone in case you want to read more: http://www.rawarrior.com/tag/prednisone-and-rheumatoid-arthritis/