I honestly don't know if the biologics work through the kidneys--I don't think they do, but I'm not sure. Do I think you're a wimp for considering adding them to your cocktail because you do not have daily disabling pain? Heck no. Why should have any pain at all? I don't think it's normal to have pain, and if you're getting pain 50% of the time, that's pretty routine. In any case, you could always ask. It's has surprised me lately how many rheumy's tend to avoid the biologics. Is it the expense? My rheumy has supported the biologics from day one. It is standard to try mtx alone first, but he was even willing to skip that step. I think most insurance companies only require you to fail one DMARD before graduating to the biologics. I failed sulfasalazine. It sounds like you're partially failing mtx. Prednisone is not a drug you want to stay on forever, and most insurance companies would support that. It's cheap, but dangerous. Adding a biologic to the mtx could make all the difference in the world for you.
At least ask your rheumy about them.
Hmmm, I wonder why the self-insured cannot get injectables? I believe the self-insured payer much higher premiums than the rest of us who have insurance through an employer, so it would stand to reason that it would include injectables. That really bites... I'm sorry, I really don't have any advice for you. I hope it works out for you, though.
Dear Oklahoma Girl,
Yikes, really the only medications for autoimmune diseases act at suppressing the immune system...thus "autoimmune=too much immune". What immune condition do you currently suffer that makes Enbrel or Humira a no-no in your case?
NSAIDS are pretty much the least of the immunosuppressive medications...but they really only control symptoms, they do nothing to halt the progression of the disease.
Antibiotics was once a first line treatment for RA. So it may be that you can work with that sort of therapy.
Even with strict monitoring, would you not be able to start a biologic injection?
Hi Yalinda, Did you ask your rheumy about the biologics? I'm wondering why he would choose to up your prednisone without even trying the biologics. I've always believed prednisone to be a last resort drug. Of course, the biologics are expensive and are not for everyone. On the positive side, I never felt better when I took prednisone (it was a high dose). I hope it does the same for you.
Yalinda, El & Oklahoma Girl...you all have such great input on the biologic useage.
Oklahoma Girl: I was thinking about your case & did some looking into my texts for RA treatments. I understand the immunodifiecency problem. Say for instance with cancer patients, their chemo is sometimes delayed due to their white blood cell count being too low...so it's the same scenario here as well.
I've found some antirheumatics, maybe you've been on them already...but just thought I would put it out there for you & anyone else that might be looking for a "what the heck do I try next" treatment. These have sorta a less severe action on the immune system:
What have you been on already & failed?
The best to you...take care.
Yalinda, I hear you about the prednisone dose thang. The week that I took it, I started at 80 mg, and then tapered down to 10mg. By the time I got to 20mg/day, I was dying. That's why when I hear people maintaining on 2mg-5mg/day I'm amazed that the prednisone is doing anything for them at all!? I guess it's just what your body gets used to, though. When I was put on pred., I was in a major flare and the doctor felt sorry for me; hence the high dose. My rheumy had a fit when I told him about it (ER doctor gave me the pred.); he would never have put me on such a high dose. In any case, I hope you have a better day today, and have fun at your conference! Take some extra tramadol with you (or are you taking that?)!