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mackie
01-12-2008, 06:39 PM
Hi everyone,

Does anyone have experience with humira or rumitrex? I am on 20mg or methotrexate per week and 10mg of prednisone per day and it's still not enough to take care of my joint pain and recurrent pericarditis and pleurisy, so my doc is considering adding one of these drugs. They sounds pretty scary so my husband and I are kind of hesitant about adding them to the cocktail I'm already on.

What do you think?

Faith
01-13-2008, 12:46 AM
Hi Mackie,

I know of someone whom is on humira; she loves it but also states it's very expensive and her insurance won't cover it. I would check with your insurance on both and see what they say as far as coverage.

I know of someone else on Remicade (via IV) and, again if she didn't have insurance it would be extremely expensive. I don't have info on the rumitrex. I am sorry.

Take care,

Faith

Saysusie
01-13-2008, 11:26 AM
Humira is another immunosuppressant. It is called a Tumor Necrosis Factor (TNF) blocker. HUMIRA is used in adults to reduce the signs and symptoms of:
moderate to severe Lupus in adults. Humira reduces the effects of a substance in the body that can cause inflammation. HUMIRA can be used alone or with methotrexate or with certain other medicines to prevent further damage to your bones, tissues and joints. Humira can lower the blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. To be sure your blood cells do not get too low, your blood will need to be tested on a regular basis.

I could find nothing on rumitrex. Could you check the spelling and get back to us?

Peace and Blessings
Saysusie

mackie
01-13-2008, 03:19 PM
Hi saysusie,

Thanks for the info on Humira. That's about what we have learned so far and we're on the fence about whether we should add it to what I'm already taking. It sounds pretty scary, although on days where my joints are bad I wonder if we really have much choice.

The other drug is Rituxan....sorry about the brain fart on the drug name. My lupus has decided to pay a visit to my cranium recently.

Thanks for your help!

mackie

Saysusie
01-14-2008, 09:09 AM
Oh...ok. I know a little about Rituxan (Rituximab):lol: This is a drug which has been used to treat a type of cancer. However, it has been found to be very effective at treating lupus. Just one injection can ease symptoms for a year or more. The drug targets the production of "B" cells. Since lupus affects each person differently, it was found that ways that patients improved on this drug was also very different. Some had less joint pain; some had fewer skin rashes. But everyone who had fewer B cells had significantly improved health.

Here is an article I found about Rituxan:

Current lupus treatments are laden with severe side effects. The anti-inflammatory drugs used to dampen the immune system leave patients vulnerable to infection, while steroids at high levels can cause an array of problems, everything from thinning bones, weight gain, weak muscles, and heart disease to glaucoma and depression.
The difference in side effects is a result of the precision, or lack thereof, of the medicines. Current lupus treatments affect nearly all the cells of the body, including healthy and vital cells. In contrast, rituximab targets only B cells and is aimed at lowering their numbers. That's why the drug is available to lymphoma patients: Most have too many B cells, which make antibodies that flag down and kill microbes and other invaders in the body.
Lupus is also a problem with B cells: They're found in the wrong proportion in the body's blood and tissue, and they're often misguided, making too many antibodies that mistakenly attack the body itself. The infighting clogs up the body with cellular debris, causing a variety of symptoms; then when the immune system detects the problem, it tries to ease up, leaving the patient open to infection.
Lupus patients tend to have fewer B cells than normal, but their B cells are hyperactive and function in a very abnormal way. The immune system is hyperactive but disorganized; it's over-reacting to some things but not enough to other things.
It was Looney's idea to target B cells to treat lupus. A great deal of traditional research had pointed to other immune cells known as T cells as the major culprit. But Looney and his team uncovered a more complicated process than had been imagined, where cooperation between B and T cells is at the core of the disease. The success with rituximab opens up a whole new vista targeting B cells, reducing their numbers, and ridding the body of errant B cells for treating the disease."

HOWEVER...HERE IS ANOTHER ARTICLE THAT I FOUND ABOUT DEATHS DUE TO RITUXAN:

"In December 2006, following the deaths of two lupus patients, a new warning was issued for the monoclonal antibody rituximab used off label for RA and lupus.


The U.S. Food and Drug Administration has issued a new warning for Rituxan after the death of two patients with systemic lupus erythematosus (SLE) who were being treated with Rituxan. The cause of death was a brain infection known as progressive multifocal leukoencephalopathy or PML, which had previously been associated with Rituxan in people who were immunosuppressed. Immunosuppression, a condition of decreased immune function, is seen in people with acquired immune deficiency syndrome (AIDS) and in people being treated with immunosuppressant drugs such as methotrexate.

Rituxan is the brand name for rituximab, a monoclonal antibody, produced by Biogen Idec and Genetech. Rituximab was first introduced as a treatment for non-Hodgkin's leukemia and B-cell leukemia. It is also used for rheumatoid arthritis and off label for several autoimmune conditions including systemic lupus. Rituxan is usually used in combination with another immunosuppressant medication.

Rituximab decreases the production of specific white blood cells associated with antibody production. Besides interfering with the production of autoantibodies, Rituximab interferes with the immune system's ability to fight against infection. In patients who are immunosuppressed Rituximab opens the doors to opportunistic infections. Opportunistic infections are infections caused by organisms such as yeast that are not usually the cause of serious disease.

Most cases of PML have traditionally occurred in patients with AIDS. Opportunistic infections are one of the leading causes of death in patients with AIDS as their immune systems become too weak to fight.

In a Marketwatch alert, it was reported that on December 19, 2006 Biogen Idec and Genetech company officials advised physicians to watch for signs of PML in their patients on Rituximab. Early symptoms of PML include problems with vision, coordination or balance.

Other warnings issued for rituximab previously include warnings for symptoms of oral ulceration and an increased risk of developing viral infections including hepatitis. In addition, Rituxan has been reported to cause bowel and gastrointestinal disease.

In an FDA alert on Rituxan issued on December 18, 2006 officials advised doctors to discuss the chances of PML with their patients on Rituxan, cautioning that there is no known treatment available for PML. The FDA also clarified that Rituximab is not an approved medication for patients with systemic lupus. The risk of developing PML can occur as long as one year after the last injection of Rituxan, making follow-up with patients previously treated critically important.

Although rituximab is currently being studied in clinical trials for patients with SLE, the two lupus patients who died were not enrolled in clinical trials."

Have a thorough discussion with your doctor about the benefits of using either drug, what you and your doctor hope to improve and what side effects to expect. I wish you the very best.

Peace and Blessings
Saysusie