I'd like to meet:
Anyone that struggles with RA and would like to share stories, share information, vent, and meet new friends!
MEDICATIONS
CORTICOSTEROIDSDrugs in this class include betamethasone (Celestone Soluspan), cortisone (Cortone), dexamethasone (Decadron), methylprednisolone (SoluMedrol, DepoMedrol), prednisolone (Delta-Cortef), prednisone (Deltasone, Orasone), and triamcinolone (Aristocort).How corticosteroids work: These drugs decrease swelling and inflammation by suppressing immune response.
DMARDS
There are a variety of medications that work by altering the immune system function to halt the underlying processes that cause certain forms of inflammatory arthritis including rheumatoid arthritis (RA), ankylosing spondylitis, and psoriatic arthritis. These are called disease-modifying antirheumatic drugs or DMARDs for short.
Drugs in this class include azathioprine (Imuran), cyclosporine (Sandimmune, Neoral), gold salts (Ridaura, Solganal, Aurolate, Myochrysine), hydroxychloroquine (Plaquenil), leflunomide (Arava), methotrexate (Rheumatrex), penicillamine (Cuprimine), and sulfasalazine (Azulfidine).
BIOLOGICS: Tumor Necrosis Factor (TNF) blockers
This class of DMARDs is known as biologic response modifiers. TNF is a cytokine, or cell protein, that acts as an inflammatory agent in rheumatoid arthritis. TNF blockers, or anti-TNF medications, target or block this cytokine and can help reduce pain, morning stiffness and tender or swollen joints -- usually within one or two weeks after treatment begins. There is evidence that TNF blockers may halt progression of disease. These medications often are taken with the immunosuppressant methotrexate. TNF blockers approved for treatment of rheumatoid arthritis are abatacept (Orencia), etanercept (Enbrel), infliximab (Remicade), Rituxan, and adalimumab (Humira).
Some information about each drug:
ENBREL
Enbrel reduces joint inflammation by blocking a cytokine called tumor necrosis factor, or TNF.
Enbrel is given by self-injection under the skin once or twice a week. Many people learn to give their own injections or receive them from a family member who has received proper instruction. A kit is available from the manufacturer that makes drawing up the medicine and injecting it easier.
Enbrel may cause irritation at the injection site, which is diminished by applying a cold pack to the injection site prior to injection.
Enbrel's effect can also weaken the immune system. Although rare, some people have developed serious infections while taking Enbrel. Anyone with a serious infection should stop taking Enbrel and resume it after being advised by a doctor. If you develop an infection, let your doctor know immediately as you need to be monitored closely.
Pregnant women should not take Enbrel because the effects on a developing child are unknown.
HUMIRA
Humira also blocks the cytokine tumor necrosis factor. The drug is an injection that can be self-administered. It is usually taken once every two weeks.
Rare cases of severe allergic reactions and blood cell deficiencies have occurred with Humira. Bruising or bleeding can be a sign of blood cell problems and should be reported to your doctor immediately.
In addition, serious infections have been seen in clinical trials when Humira was taken with the rheumatoid arthritis drug Kineret.
REMICADE
Like Enbrel and Humira, Remicade reduces inflammation by blocking the cytokine tumor necrosis factor. Remicade is given by intravenous infusion in the doctor's office or hospital. Each infusion takes about two hours. The intravenous treatments are given three times during the first six weeks of therapy, then every eight weeks. Remicade is given with methotrexate for treating RA.
As with other biologics, treatments may weaken the body's ability to fight infection. If you have any signs of infection such as a fever over 100 degrees F, sweats or chills, skin rash, or other symptoms that cause concern, contact your doctor right away.
With any treatment, it is important to meet with your doctor regularly so he or she can closely monitor you to detect the development of any side effects and monitor your treatment if necessary. Your doctor may periodically order blood tests or other tests to determine the effectiveness of your treatment and the presence of any side effects.
RITUXAN
Rituxan is approved for patients with moderate-to-severe RA who have not improved with TNF antagonists, such as Enbrel or Remicade. Rituxan is given as two infusions in the vein -- separated by two weeks -- in combination with weekly methotrexate.
The most common side effects include infections and reactions while the medicine is given (called infusion reactions). Symptoms of infusion reactions include flu-like illness, fever, chills, nausea, and headache.
ORENCIA
Orencia is approved for the treatment of moderate to severe rheumatoid arthritis. Orencia blocks signals that are needed to activate T-cells of the immune system. Activated T-cells play an important role in the development of rheumatoid arthritis.
Orencia is approved to reduce the symptoms of RA in patients not helped by other biologics. It can be taken alone or with other medications except biologics.
Orencia is given by intravenous infusion. Adverse reactions include infection and serious allergic reaction. Patients shouldn't receive live vaccines while taking Orencia or within three months of stopping the drug. Caution should be used in prescribing Orencia for patients with chronic obstructive pulmonary disease (COPD). Those patients' respiratory health should be monitored. Orencia should be used during pregnancy only if clearly needed. Nursing mothers should talk to their doctors about the risks and benefits of taking Orencia.
Reviewed by the doctors at The Cleveland Clinic Department of Rheumatic and Immunologic Diseases.
Future treatments:Scientists throughout the world are studying many promising areas of new treatment approaches for rheumatoid arthritis. These areas include treatments that block the action of the special inflammation factors, such as tumor necrosis factor (TNFalpha) and interleukin-1 (IL-1), as described above. Many other drugs are being developed that act against certain critical white blood cells involved in rheumatoid inflammation. Also, new NSAIDs with mechanisms of action that are different from current drugs are on the horizon.Better methods of more accurately defining which patients are more likely to develop more aggressive disease are becoming available. Recent antibody research has found that the presence of citrulline antibodies in the blood (see above in diagnosis) has been associated with a greater tendency toward more destructive forms of rheumatoid arthritis.Studies involving various types of the connective tissue collagen are in progress and show encouraging signs of reducing rheumatoid disease activity. Finally, genetic research and engineering is likely to bring forth many new avenues of earlier diagnosis and accurate treatment in the near future. Gene profiling, also known as gene array analysis, is being identified as a helpful method of defining which people will respond to which medications. Studies are underway that are using gene array analysis to determine which patients will be at more risk for more aggressive disease. This is all occurring because of technology improvements. We are at the threshold of tremendous improvements in the way rheumatoid arthritis is managed.
PHYSICAL AIDS AND COPING
MEDITATION
HOT PARAFFIN WAX TREATMENTS
GREEN TEA
HEATING PAD
COLD COMPRESSES
I've used this product and it does help.
A STYLISH WALKING CANE
A PET CAN BRING JOY!
FAMOUS PEOPLE THAT HAVE SUFFERED WITH RA
Many famous people have suffered from RA. Pierre-Auguste Renoir, the 19th-century painter, developed RA in mid-life. His hands became so crippled that his paint brush had to be wedged between his fingers. However, he kept his sense of humour. He joked that he never finished a nude painting until he thought he could pinch it!
Comedy queen Lucille Ball of "I Love Lucy" fame had rheumatoid arthritis when she was 17 but that didn’t stop her from pursuing her dreams. Her first attack came while she was working as a model for Hattie Carnegie’s famous dress shop. She felt excruciating pain in her legs and the doctor who saw her said she would probably end up in a wheelchair as a result of the disease. Lucy was later referred to an orthopedic clinic near Columbia University where she was given experimental "horse serum" shots for several weeks that drained her money but didn’t stop the pain. Frightened and discouraged, she returned to her parent’s home in Jamestown, New York."Gradually the pain subsided and finally one day with the support of her father and doctor, Lucy stood up, feeling wobbly and unsteady. Her left leg was now somewhat shorter than her right leg and it pulled sideways. To correct this, she began wearing a 20 - pound weight in one of her black orthopedic shoes. Though Lucy had residual pain she was able to take a part offered her with the Jamestown Players and she later returned to New York City in search of her dreams," said Carol and Richard Eustice - the people behind About.com’s Arthritis Guide who both have rheumatoid arthritis as well.
Hollywood star Kathleen Turner was so bothered by the pain of rheumatoid arthritis that she had suicidal thoughts.
Rosalind Russell, star of the silver screen,
had severe RA and did much to garner support
for the advancement of research into
this disease.
Aida Turturro-
Aida Turturro plays Tony Soprano's conniving sister, Janice, on the
HBO series "The Sopranos" , AND has suffered from rheumatoid arthritis
since she was a child.
Camryn Manheim-
"I went to several doctors before visiting a rheumatologist who finally diagnosed the painful swelling and stiffness in my joints as rheumatoid arthritis," says Camryn. "It took close to eight months for me to get properly diagnosed and treated. I lost valuable time, and the joint damage I sustained is irreversible. I'm sharing my story with the hope that it will inspire others to take control of their rheumatoid arthritis by learning more about the disease and working with a rheumatologist to manage it."Camryn first noticed the pain and stiffness in her fingers while she was practicing sign language, a passion of hers for more than 20 years. Initially, Camryn was told the pain was due to aging, but because of the severity of her symptoms, Camryn knew it was something more. It wasn't until Camryn conducted her own research and consulted with a rheumatologist that she received a proper diagnosis and found a treatment regimen that worked for her. Now, Camryn's symptoms are under control and she again has the energy to enjoy her normal daily activities, like teaching sign language and playing with her four-year-old son. Camryn's rheumatologist also is managing her treatment process closely to ensure she does not endure additional joint destruction
A SLIDE SHOW ABOUT LIVING WITH RA
