The Young and the RA

Ok, so how many people are in love with the new Humira and Enbrel commercials? Don’t be afraid to raise your hand, now. For those of you still staring blankly at the screen (or with TiVo and haven’t seen a commercial in quite a while, watch some TV; you really can’t miss them). I see one every time I plop in front of the tube.   

Why do I enjoy these commercials so much, might you ask? Because they put RA in the spotlight! These advertisements tell the general public a little about rheumatoid arthritis. These ads show that RA is a disease the erodes the joint; that it isn’t the same as arthritis; that it can’t just be solved by popping an Advil. 

I’ll high-five the makers of those commercials if I ever meet them.  And, yes, I know that aren’t out there to inform but to sell. But still, props to Abbott and Amgen (the makers of Humira and Enbrel) for the ads. I’m digging them. 

Now there are a few problems with the ads, of course. The actors in them tend to be on the older side, while RA can develop at any age:

“Rheumatoid arthritis can occur at any age, but most often appears first between the ages of 25 and 50″ (Milton S. Hershey Medical Center). 

But these ads do tell people the most important thing about RA: it causes joint erosion, and you can’t ignore that:

“As your disease progresses, your X-rays can show small holes or erosions near the ends of bones and narrowing of the joint space due to loss of cartilage” (Arthritis Foundation).

So whether or not you can see or feel the damage, it is there, and it is important that you actively treat it: 

“Just a few years ago, your doctor might have only prescribed an over-the-counter pain reliever, like an analgesic or non-steroidal, anti-inflammatory drug (NSAID), until you experienced increased disease progression. Now, with the improvement of available medications, doctors know that they have to be more aggressive early on in order to prevent severe deformity and joint erosion” (Arthritis Foundation). 

Biologics such as Enbrel and Humira work to prevent joint erosion (see my post “Shooting up the good stuff”). For people who are able to take them, biologics can help keep your joints in good shape and keep you from having to have surgery or ending up in a wheelchair.

Until next time,

S.P.

As the latest and greatest drug, a lot of people out there are on biologics. Biologics are a class of drugs used to treat inflammation.  According to the American College of Rheumatology:

“A “biologic” drug copies the effects of substances naturally made by your body’s immune system. Biologic agents are genetically engineered drugs – meaning that human genes that normally guide the production of these natural human immune proteins (i.e., an antibody to TNF) are used in non-human cell cultures to produce large amounts of a biologic drug. These drugs are given to lessen inflammation by interfering with biologic substances that cause or worsen inflammation. These new biologic agents can specifically affect some of the abnormalities of the immune system that lead to the joint inflammation and other abnormalities seen in rheumatoid arthritis and so help treat its symptoms.” 

This class of drugs includes Enbrel, Humira, Remicade and several others. They are taken either as a shot — some can be taken twice a week and others every two weeks — or through an IV — while taken only once a month or so, takes several hours and you have to have a health professional set it up. I have only tried Enbrel and Humira (which I am currently on), so I haven’t done the IV before.

I have heard stories about people experiencing improvements immediately after taking the drug, but it didn’t take effect for me for several months later. And I have talked to several people who had very adverse reactions to one or all of the biologics they have tried. While some reactions were so severe that the person had to be taken off the biologic, some were much more moderate, such as injection-site reaction: “Skin reactions to injection occur in less than 30 percent of patients, and such patients usually complain of localized rash, burning, or itching at the site of injection” (American College of Rheumatology) For those with these lesser adverse reactions, I can offer you at least a little help. Here are a few recommendations for dealing with injection-site reactions:

• Make sure you are sticking the needle deep enough. Many people have reactions when the drug is injected right under the skin rather than deeper. So make sure the needle is on all the way before injecting the medication.
• Get yourself some hydrocortisone cream. Put in on the injection site directly after taking the shot or later on if a rash pops up. It is amazing. I use it all the time to deal with injection rashes.
•  Put a cold compress on the site. It can help reduce inflammation and irritation.

Many people have even more sever reactions, though, that can be treated with any of the above. For those people, see your doctor immediately. About.com talks about several of the side effects you may have when taking a biologic:

“Two major concerns with these drugs include the risk of serious infection or Lymphoma. Rheumatoid arthritis patients have an increased risk of developing these two problems compared to the general population. In fact, patients who have the most severe cases of RA are more likely to develop lymphoma than those with milder disease, so it will be of interest to see over time whether treatment with these medications to control disease activity may actually decrease the incidence of this problem. There is evidence that the drugs increase the risk of developing unusual infections like tuberculosis (it is recommended that all patients be screened with a skin test to check for prior exposure to TB before beginning therapy with a TNF blocker). Other serious infections have also been reported since the drug has been on the market.” 

 So, while some people may not be able to use biologics, it is a great option for those who can. Talk to your rheumatologist about them. Try one out and see if it works for you. 

Until next time,

S.P. 

We all eat. It’s how we survive, right? Well, what effects do our diets have on our RA? There has been research about the benefits of a vegetarian diet:

“Fats from animal foods enhance the production of certain chemicals in the body that produce inflammation, and several studies have shown that people with RA improve on a vegetarian diet” (Bastyr Center for Natural Health).   

Now, I have been a vegetarian since I was in the second grade. I didn’t become one because of animal rights. I didn’t become one because anyone in my family was. And I definitely didn’t become one because it was cool. Why did I become a vegetarian? I did it to spite my father, I guess. (It’s a very long story, if you are interested in hearing it message me, and I’d love to tell you the whole thing.)

Anyways, long story short, I haven’t eaten meat in close to 15 years now (well, at least knowingly), and now I find the idea of eating it repulsive. (Not that I mind others eating meat. Hey, all my brother eats is steak and pizza, and my boyfriend’s a hunter!)  

Well, despite my diet, I got RA, so obviously having a vegetarian diet isn’t any sort of preventative measure, but my diet may be helping keep my RA under control.  My diet does have one draw back however: I don’t eat fish. Fish is a great source of omega-3, which has been seen to help RA (see my earlier post about omega-3).  So, a Mediterranean diet might be a better recommendation for those with RA:

“A 2003 study reported that RA patients who followed it experienced reduced inflammatory activity, improved physical function and improved vitality compared to those on a standard Western diet. The Mediterranean diet is also rich in heart-healthy fiber and nutrients, omega-3 fatty acids, and antioxidants” (My RACentral.com).  

So what else should you change in your diet? Research has shown that dairy can also aggravate RA (British Medical Journal). So stay away from the milk and cheese as much as possible!  

I know that making such big changes in your diet can be hard. I didn’t even become a vegetarian over night. I took months to give up bacon and Canadian bacon on my pizza! But I was willing to suck it up to show my dad that I was a “real” vegetarian. (Yeah, dumb reason, I know. But I was nine. What do you expect?)

The point is, isn’t it worth it to give up eating steak, hamburgers and cheese every day (you can still have them on occasion!) to get rid of joint pain? I think it is. I’ve already reduced the amount of cheese I eat, which was pretty hard since I am addicted to the stuff. So just try it out. You might be surprised at how good you feel.

Until next time,

S.P.