Rheumatoid arthritis and TNF-a blockers

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Veteran Member

Date Joined Apr 2006
Total Posts : 1173
   Posted 9/23/2008 11:53 AM (GMT -7)   
Hi, I'm your neighbor from the Lyme HW forum and thought of each of you when this report was forwarded to me through the PA Yahoo Lyme forum, so passing along for educational and hopefully preventative purposes.  Blessings, Sojourner
Below is a MedWatch posting from the CDC. This will be of interest to those being treated for rheumatoid arthritis with TNF-a blockers. If you are being treated with these, you should educate yourself about the risks of contracting a fungal disease such as histoplasmosis,
coccidioidomycosis, blastomycosis, aspergillosis, etc. and be aware of their symptoms.

Avoiding those infections that are prevalent in your area will vary, but in general if you are being treated with TNF-a blockers, you will want to consider using HEPA filters in your home, avoid dusty or damp places - particularly home demolition dust, exposure to newly disturbed soil,
exposure to compost piles (home and municipal), exposure to bird and bat droppings (histoplasmosis is often seen in pigeon owners and cavers), and exposure to windy conditions which tend to spread the spores. You should discuss the risks in your area with your doctor. We are all exposed to many fungi everyday, but TNF-a blockers suppress the immune
system and make people more vulnerable.

Here are links to the CDC information pages on the mentioned diseases.

http://www.cdc. gov/nczved/ dfbmd/disease_ listing/histopla smosis_gi. html
http://www.cdc. gov/nczved/ dfbmd/disease_ listing/coccidio idomycosis_ gi.html
http://www.cdc. gov/nczved/ dfbmd/disease_ listing/aspergil losis_gi. html
http://www.cdc. gov/nczved/ dfbmd/disease_ listing/blastomy cosis_gi. html#how
MedWatch = The FDA Safety Information and Adverse Event Reporting Program

*Tumor necrosis factor-alpha blockers (TNF blockers), Cimzia
(certolizumab pegol), Enbrel (etanercept) , Humira (adalimumab) , and Remicade (infliximab) *
*Audience: *Rheumatological, gastroenterological and infectious disease healthcare professionals

FDA notified healthcare professionals that pulmonary and disseminated histoplasmosis, coccidioidomycosis, blastomycosis and other opportunistic infections are not consistently recognized in patients taking tumor necrosis factor-α blockers (TNF blockers). This has
resulted in delays in appropriate treatment, sometimes resulting in death. For patients taking TNF blockers who present with signs and symptoms of possible systemic fungal infection, such as fever, malaise, weight loss, sweats, cough, dypsnea, and/or pulmonary infiltrates, or other serious systemic illness with or without concomitant shock,
healthcare professionals should ascertain if patients live in or have traveled to areas of endemic mycoses. For patients at risk of histoplasmosis and other invasive fungal infections, clinicians should consider empiric antifungal treatment until the pathogen(s) are identified.

Read the complete MedWatch 2008 Safety summary, including links to the Information for Healthcare Professionals page, FDA press release and previous MedWatch alert on these products, at:
http://www.fda. gov/medwatch/ safety/2008/ safety08. htm#TNF2

Regular Member

Date Joined Jul 2008
Total Posts : 117
   Posted 9/26/2008 6:16 AM (GMT -7)   
Thanks for your concern.
Looks like you have got the attention of a good lot of us
God bless you!!!
Love Debbie

Veteran Member

Date Joined Mar 2005
Total Posts : 3199
   Posted 9/26/2008 4:08 PM (GMT -7)   
thanks for all the info! :)
Moderator of Arthritis Forum
Confirmed Diagnosis of - Psoriatic Arthritis/Spondylitis/Graves Disease/GERD/Scoliosis/Hiatal Hernia/Graves Disease of the Eyes/Chronic UTIs/Migraines/Hypertension
Current Meds -  Enbrel/Prilosec/Synthroid/Nitrofurantoin/Midrin/HYZAAR/Methotrexate
Past Meds - Inderal/PTU/Prednisone/Voltaren/Feldene/Mobic/Cortisone and Steroid Shots/HCTZ

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