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Fibromyalgia board

Hey Blue:

I managed to muster up information about the most popular treatment methods for RA. Of course you know this will probably be a "double" post (I hope ;) ) because I want to give you as much info as I can besides simply posting a list of meds. You ready? Here goes:

First, here's my usual "disclaminer"! :) The following info has been gathered from various sources, none of the info is copywrite protected. What is listed here, is meant to be shared. I have paraphrased or added personal comments (in italics) where I felt necessary.

Rheumatoid Arthritis

Rheumatoid Arthritis (RA) is a chronic, inflammatory disease mainly characterized by inflammation of the lining, or synovium, of the joints. Rheumatoid Arthritis is considered to be an autoimmune disease - like Crohn’s Disease, Lupus, Multiple Sclerosis and other ailments.I'm curious to know if these "other ailments" could include FM. ??? For reasons that are not yet clear, in autoimmune diseases the immune system loses its ability to tell the difference between foreign substances (antigens) and its own cells and tissues. The immune system then makes antibodies directed against the "self." These antibodies, called "auto-antibodies," react with the "self" antigens to form immune complexes. The immune complexes build up in the tissues and can cause inflammation, injury to tissues, and pain.Normally, our body's immune system will defend itself against an infection (foriegn substance) although when our immune system becomes "confused" the defense antibodies keep building and building until they have nowhere to go, thereby resulting in swelling. Acting like a an over inflated tire, causing it to swell beyond it's capacity. Any type of abnormal "overgrowth" within our body's mess with the natural process of how our internal "defense mechanism" works to protects us. An antibody known as a rheumatoid factor is typically elevated and is typcially the indicator of the disease (though approximately 20 percent of people with RA will have a negative rheumatoid factor test and some people who don’t have RA will test positive.) As most of us know, the RH Factor is determined through a blood test. Most of us with FM have had this test done, most likely more than once.

Rheumatoid Arthritis affects about 1%of the population, and can affect anyone, including children (Juvenile Rheumatoid Arthritis), although onset usually occurs between 30 and 50 years of age and 70% of those with RA are women. The reason women are more likely to suffer from RA (and most other auto-immune conditions) is not clear, though it appears that hormones like cortisol, progesterone, and estrogen are the most likely causes. I wonder if this could be one of the reasons that more women than men have FM, MS and Lupus?

There are two basic types of treatments for Rheumatoid Arthritis: those aimed at the underlying auto-immune disease; and those used to relieve pain and inflammation. Treatments aimed at the underlying auto-immune disease include the DMARD medications (disease-modifying antirheumatic drugs) such as the antimalarial drug Plaquenil etc. (Hydroxychloroquine), as well as a new class of RA drugs known as biologic response modifiers such as Enbrel (Etanercept) and Remicade (Infliximab). Rheumatoid Arthritis pain and inflammation relief treatments include nonsteroidal anti-inflammatory drugs (NSAID's) like the COX-2 med Celebrex (Celecoxib) and corticosteroids like Deltasone etc. (Prednisone). Celebrex has been suggested for short term use given the recent FDA warnings about this type of med (Cox2 Inhibitors). IMO, I would talk to your doctor before using this specific anti-inflammatory. There ARE many other anti-inflammatory meds out there that are safer. I use ARTHOTEC for inflammation and it works well.

A couple of novel treatment approaches also seem able to help some individuals with Rheumatoid Arthritis. Antibiotic Therapy is based on the theory that inflammatory rheumatic diseases such as rheumatoid arthritis, scleroderma, lupus, juvenile rheumatoid arthritis, polymyositis, ankylosing spondylitis, etc. have an infectious cause, namely mycoplasma and other bacterial L forms - primitive bacteria like Chlamydia, Brucella, Borrelia, etc.. Notice how some of these bacterial infections have popped up in people with Fibromyalgia. Using low dose antibiotics, particularly from the tetracycline family, the disease is attacked at its source. Since basic tetracycline does not get into joint fluid in high levels, doctors usually prescribe tetracycline derivatives such as minocycline and doxycycline, which accumulate in high levels in joint fluid. The course of therapy usually begins with a series of daily intravenous antibiotics for five to seven days. After the initial daily series, IV's may be administered weekly, every other week or as the physician determines for the individual patient. The IV's are continued until all lab figures return to normal, at which point oral antibiotics are taken. This is also the method typically used to treat Mono, which, again, seems to a common infection that many of us with FM have encountered at one time or another in our lives.

Another interesting treatment approach for RA involves a gluten-free diet. Blue, I thought that this piece of info about diet would interest you, as well as other with RA. Also, it is this type of diet that has been recommened for FM patients. See a connection here? Several studies have found that some individuals with Rheumatoid Arthritis benefit from a gluten-free diet. Gluten is a protein found in grains like wheat, rye and oats. Although the exact connection between diet and autoimmune conditions like RA is not understood, clinical observation has long known that inflammation of the gut is frequently associated with inflammation of the joints and vice versa. Some researchers now believe that exposure to certain allergens like gluten and another kind of dietary protein called “lectin”, may actually trigger autoimmune disorders like RA in individuals with pre-existing genetic susceptibly.

Okay, Blue, here is the info about Humira, and at the end, I'll list the "Self-care" remedies rated most popular by RA patients.

First let me say, I found that Humira is very similar to Remicade as far as it's components. Humira is administered the same way Enbrel is, tho, Humira does not need to be injected as often as Enbrel. I also found a "warning" by Abbott Labs, the manufacturerer of Humira in regards to an adverse reaction with a certain medication that is used to sometimes treat RA and Cancer patients. I will also list info about that interaction. Though the other RA treatments like Remicade and Enbrel boasted that they work well with other meds. This is the only treatment I found that adversely interacts with this one particular medication. Although, like many medications, there are always precautions and drug interactions that are listed when you recieve your prescription. We all know that we should read that paper, tho a lot of us don't (raising my hand! ). The one "precaution" that kept popping up referred to anaphalaxic as one of those precautions. We also know that you should talk in depth to your doctor about ALL possible reactions and side effects you may experience with any of these treatments.

HUMIRA is a biologic disease-modifying medicine that interrupts the inflammation process and helps slow the progression of rheumatoid arthritis (RA). The active ingredient resembles an antibody that normally occurs in your body, so it helps your body to fight RA the way it would if it could. HUMIRA can also be taken with pain medications and other disease modifying drugs. It resembles antibodies normally found in the body. As HUMIRA binds and blocks the activity of TNF-a, it reduces the signs and symptoms of RA and slows the progression of structural joint damage caused by the disease.

How is HUMIRA different from other medications that treat RA?
HUMIRA is a biologic disease-modifying antirheumatic drug, also called a DMARD. Biologic DMARDS (DMARDS were mentioned in the first couple of my posts referring to the info of how these treatments work ) are among the most recent RA treatments approved by the FDA and are approved for reducing the signs and symptoms, and slowing the progression of structural damage to the joints caused by RA.

Other biologic DMARDs include Enbrel® and Remicade®. Enbrel is injected once or twice weekly, and Remicade requires a visit to the doctor to administer the medication. HUMIRA is an effective biologic DMARD and was the most widely studied TNF-a antagonist when it was submitted to the FDA.

HUMIRA can be injected by you or a loved one in the convenience of your own home. And, it usually only needs to be taken once every two weeks - giving you more freedom to live your life without having to always think about taking your medication.

The most common side effects of HUMIRA are:
injection site reactions
upper respiratory and sinus infections
injection site pain

A substance that is used to treat rheumatoid arthritis, and is being studied in the treatment of cancer. Anakinra blocks the action of interleukin 1 (IL-1). It belongs to the family of drugs called interleukin receptor antagonists. Also called Kinaret®. (interleukin is one of the protiens referred to in my thread about FM being classified as a disease. This protien is one of the protiens that, when elevated, "poison" your immune system, which regarding FM, damages the neurotransmitters that are meant to block pain. Often when your doc orders a CBC to check your blood, there is a section in the test that reads protien levels, it is normal to see elevated protien levels in FM, RA, Lupus and MS patients )

Use with Anakinra This is taken from the Precautions and Drug Interactions sections of the information literature that is packaged with Humira.
Serious infections were seen in clinical studies with concurrent use of nakinra
(an interleukin-1 antagonist) and another TNF-blocking agent, with no added
benefit. Because of the nature of the adverse events seen with this combination therapy, similar toxicities may also result from combination of anakinra and other TNF blocking agents. Therefore, the combination of HUMIRA and anakinra is not recommended (see PRECAUTIONS, Drug Interactions). Remember, I said that reports of anaphylaxis was found in reference to the list of severe side effects of any of these treatments. Again, you know to speak in depth to your doctor regarding any of these treatments and their possible side effects. I'm not promoting any particular treatment, I am merely offering you information that is available to the public, your doctor knows you best and will know which is best for you.

Okay, enough of the technical stuff, here comes the info from a group of your "peers". LOL Sounds like a game show! Here's the top rated self treatments for RA, rated by other RA patients. There is only one list of preferred prescription meds by other RA patients.

The numbers next to the "treatment" are the rating value from 1 thru 10. 10 of course being the best.

Self-care Treatments: Top 3 Remedies
Laughter / Humor Therapy: 10 Blue, I think you've got this one covered!
Patient Education: 9.6 The list of education may not have been approved by board policy, so I'll just say that "self-education" by any means you have available is always a 10!
Hydrothermal Therapy: Sauna / Steam Baths: 9.3

Nutritional Supplements Top 3 Remedies
MSM (Methylsulfonylmethane) 10
Vitamin C (Ascorbic Acid) 10
Multi-Vitamin; Mineral Supplements (combined ratings)

Complementary and Alternative Therapies Top 3 Remedies
Bodywork Therapies: Jaffe-Mellor Technique 8.4 I have NO idea what type of therapy this Jaffe-Mellor Technique is! Anyone know?
Bodywork Therapies: Therapeutic Massage: 7.8
Chiropractic Therapy 6.8

Over-the-counter Medications and Products Top 3 Remedies
Therabath etc. (Paraffin Wax Baths) 9.2
Magnetic Therapy: Pulsed Magnetic Fields (PMF) 8.9
Topical Painkillers: Methyl Salicylate Formulas 8.3

Prescription Medications and Doctor Procedures Top 3 Remedies
Solganal (Aurothioglucose) 9.7
Flexeril etc. (Cyclobenzaprine) 9.7
Methadone etc. (Methadone Hydrochloride) 9.3

AND FINALLY! Here is a list of the most popular RA specific treatments:
Top 10 Remedies for Rheumatoid Arthritis Remedy Name Weighted Rating
(0 = poorest; 10 = best)

Antibiotic Therapy 8.1
Enbrel (Etanercept) 7.2
Remicade (Infliximab) 6.9
Deltasone etc. (Prednisone) 6.8
Plaquenil etc. (Hydroxychloroquine) 6.3
Rheumatrex etc. (Methotrexate) 5.9
Arava (Leflunomide) 5.8
Celebrex (Celecoxib) 5.5
Kineret (Anakinra) 5.2
Azulfidine etc. (Sulfasalazine) 4.2

Okay, there ya go! Keep us posted on how your treatment goes, whichever one you choose. You too Glojer.

Love to you!