Get to know the wide range of treatments for rheumatoid arthritis, osteoarthritis
and other types of arthritis-related conditions. Learn what the experts say and what you must know before taking new medications,
deciding on surgery or trying alternative therapies, like supplements and herbs.
**Penny is currently
receiving an infusion drip .. it is Remicade and it works to help control the pain and discomfort from Arthritis.. Penny
also takes Celebrex and a steroid to help with the constant pain from inflamation.**
Fibromyalgia and Chronic Fatigue
Fibromyalgia (pronounced fie-bro-my-AL-juh)
is a real medical condition. It includes all-over muscle pain that can make it hard to do even day-to-day tasks. The pain
may vary from mild to severe.
pain from fibromyalgia is one of the most common types of chronic widespread pain in the U.S. People with fibromyalgia may
not know what is wrong with them or what is causing their pain. They may feel alone.
Once, there was no FDA-approved treatment for fibromyalgia.
LYRICA®(pregabalin) capsules CV is the first FDA-approved
medicine to treat fibromyalgia in adults, 18 years and older. It can help relieve the unique pain of fibromyalgia.
This Web site will help you learn
more about fibromyalgia and LYRICA.
Next: Possible Causes
Cymbalta and Fibromyalgia
has been approved by the FDA for the management of fibromyalgia and has been demonstrated to help reduce pain and improve
function. Cymbalta is available only by prescription.
When Cymbalta was studied in patients with fibromyalgia, many people felt significant pain
reduction, compared with patients taking placebo. Individual results may vary. Learn about how Cymbalta is believed to work.
Cymbalta Is Simple to Take
comes in a capsule and can be taken once a day to help lessen pain associated with fibromyalgia. Cymbalta can be taken with
or without food. You should not break, open, or chew the capsule. It should be swallowed whole. Make sure you take only the
dose your doctor prescribes.
is not for everyone. As with all medications, certain side effects may be experienced.
In clinical studies of fibromyalgia, the most commonly reported side effect of Cymbalta
was mild to moderate nausea. Read more about the most common side effects and potential risks associated with treatment. For complete product
information, please read the full Prescribing Information and Safety Information and Boxed Warning. Learn more about supporting someone with fibromyalgia if a friend or loved one has been diagnosed with fibromyalgia.
Psoriasis is a common skin disorder in which there is a reddish scaly rash over the elbows, knees, scalp or elsewhere. About 10-15% of people with psoriasis develop arthritis.
Ustekinumab (Stelara®) Compared to Etanercept (Enbrel®)
January 21, 2010
In September 2009, the U.S. FDA approved ustekinumab (Stelara®) for
plaque psoriasis. The biologic drug, a human monoclonal antibody, is the first in a new class of medications that work by
blocking interleukin-12 and interleukin-23, naturally-occurring proteins that help regulate the immune system but are believed
to play a role in psoriasis.
To help determine
the relative benefits and safety of ustekinumab, scientists from the University of Manchester in England compared it to another
biologic drug, etanercept (Enbrel®), which has a different method of action. A TNF-alpha inhibitor, etanercept blocks
selective steps in psoriasis’ inflammatory process. Other TNF-alpha blockers, including adalimumab (Humira®) and
infliximab (Remicade®), were not studied.
the trial, the researchers randomly assigned 903 people with moderate to severe plaque psoriasis to receive injections of
ustekinumab—either a 45 mg or 90 mg dose—or a high dose of etanercept (50 mg) over 12 weeks. Ustekinumab was administered
as two injections given the first and fourth weeks; etanercept was given as twice-weekly injections.
According to the results published in The New England Journal of Medicine,
ustekinumab showed "superior" effectiveness to etanercept over the 12-week period. More people taking ustekinumab
experienced a 75% improvement in psoriasis severity: 68% of people receiving 45 mg of ustekinumab and 74% of those receiving
the 90 mg dose, compared to 57% of people receiving etanercept. In addition, a higher proportion of people using ustekinumab
had skin clearance or minimal skin disease after 12 weeks, according to their doctors.
In a crossover study, people who didn't respond to etanercept received two injections
of ustekinumab (90 mg) at weeks 16 and 20. At week 28, the researchers reported that 49% of those patients achieved at least
75% improvement in psoriasis severity.
drugs showed similar safety profiles over the 12-week study period. Around 70% of people in all three groups experienced at
least one adverse health event. Four people in each treatment group also experienced a serious medical event.
The study was funded by Centocor, a subsidiary of
Johnson & Johnson and the marketers of Stelara® (ustekinumab).
So what does this study mean for patients with psoriasis? It's further evidence that researchers
are honing in on good targets for psoriasis treatment. "The results of this study could have implications for determining
the optimal approach to the treatment of psoriasis and, in particular, the need for therapeutic strategies targeting Th1 cells,
Th17 cells, or both to provide optimal benefit and safety," write the study authors. If your plaque psoriasis isn't well-controlled
with systemic medications, it also demonstrates the effectiveness of biologic medications.
If you are taking etanercept, and your psoriasis has improved with treatment,
this study alone isn't reason to switch treatments. The safety profile of etanercept has been established over years of clinical
use. As a relatively new drug, ustekinumab's long-term safety isn't yet fully understood. But for people with moderate to
severe plaque psoriasis who have not responded to other treatments, talk to your doctor about the benefits and risks of ustekinumab.
*~* Alert *~*
Psoriasis drug Raptiva is withdrawn due to risk of fatal brain infection.
maker of the psoriasis drug Raptiva (efalizumab) is pulling the drug from the U.S. market because of its association with a rare and usually fatal brain infection. Psoriasis
patients taking Raptiva should immediately talk to their doctor about finding an alternative treatment, says the National
Psoriasis Foundation. Stopping Raptiva abruptly could lead to a severe psoriasis flare, so patients should be sure to talk
to their doctors before they stop treatment.
the drug’s maker, has announced a phased withdrawal of the drug, which is associated with a higher risk of developing
progressive multifocal leukoencephalopathy (PML), which can attack people with weakened immune systems.
Genentech researchers say that Raptiva’s effects
typically wear off by 12 weeks after the patient’s last dose. “The risk of developing PML after 12 weeks should
be greatly reduced,” said Bruce Bebo, Ph.D., Psoriasis Foundation research director. “Raptiva has a fairly short
life in the immune system once the patient stops using the drug.”
The removal of
Raptiva underscores the need for more and better treatment options for people with psoriasis and psoriatic arthritis.
We need your help to stop this backward trend and demand that people
with psoriatic diseases have access to safe and effective treatments.
Here are three ways you can help right now:
· Write your senator and representatives in Congress, asking them to support
the Psoriasis and Psoriatic Arthritis Research, Cure and Care Act.
Donate your DNA to the National Psoriasis Victor Henschel BioBank to be used for psoriasis research.
· Support Alyssa’s Fund, a campaign dedicated to finding what role the immune system
plays in causing psoriatic diseases.
Links to Psoriasis Treatments
Humira: (also known by its generic name adalimumab) is a biologic medication approved in October 2005
by the U.S. Food and Drug Administration (FDA) for the treatment of psoriatic arthritis. In 2008 it was approved for treating psoriasis, and it is also approved for treating rheumatoid arthritis. For more information
about biologics as a class of treatment, please see the For more information about biologics as a class of treatment, please
see the biologics section.
- FDA-approved for psoriasis and psoriatic arthritis
- Patients give themselves
an injection under the skin every other week
- Patients should be screened for latent (hidden) tuberculosis (TB) before
- Long-term side effects still being evaluated
How does it work?Humira blocks tumor
necrosis factor-alpha (TNFalpha), a chemical "messenger" in the immune system that signals other cells to cause
inflammation. There is too much TNF-alpha in the skin of people with psoriasis and the joints of people with certain types
TNF-alpha can also lead to increased immune system activity through the activation of immune cells, including
T cells. T cells are a type of white blood cell in the body; in psoriasis, once T cells are mistakenly activated, they can
trigger inflammation and other immune responses and fuel the development of psoriasis lesions.
Humira helps lower the
amount of TNF-alpha, thus interrupting the inflammatory cycle of psoriasis and psoriatic arthritis and leading to improvement
in symptoms for many people who take it.
Who is a candidate?Humira is prescribed for people with moderate to
severe psoriasis and active psoriatic arthritis.
Who should not take Humira?
Caution is advised for people who experience any numbness or tingling, or have ever had a
disease that affects the nervous system.
- People with active serious
infections or a history of recurrent infections
- People with a history of heart failure
- People with multiple
sclerosis or other similar types of demyelinating neurologic diseases
- Children—the medication has not been
approved for children
Caution is also advised for the elderly, due to the already increased risk of
infection for this age group.
The impact of Humira on pregnant women or developing fetuses is not known, nor is it
known if the medication passes into breast milk in nursing women. Humira should only be given to pregnant or nursing women
if there is a clear medical need, and if this decision is reached by a patient and doctor together.
How is it used?Patients
take Humira at home by giving themselves an injection under the skin, similar to diabetes patients who give themselves insulin
injections. The recommended dose for patients with psoriatic arthritis is 40 mg every other week. Humira is designed to be
taken continuously to maintain improvement.
The medication can be prescribed by itself or in combination treatment with
methotrexate, a systemic medication prescribed for psoriasis and psoriatic arthritis. In clinical studies, people taking Humira in combination
with methotrexate for rheumatoid arthritis experienced more disease improvement than patients taking Humira or methotrexate
alone. It is also safe to take Humira with pain relievers, such as NSAIDs, that are often taken for arthritis.
Neoral: (cyclosporin) Psoriasis is affected by the immune system. It is thought
that T cells over-react to a stimulus Psoriasis conditions, causing the scaling and inflammation of the skin. Cyclosporin
can be used in severely disabling and resistant forms of these conditions to suppress the action of the T cells and therefore
improve the scaling of the skin.
Cyclosporine (brand name Neoral) is a prescription systemic medication used to treat
psoriasis. It has been available since 1995 to help prevent organ rejection in transplant patients. It can be taken by adult
patients with severe, difficult-to-treat psoriasis. In 1997, the U.S. Food and Drug Administration (FDA) approved Cyclosporine as a psoriasis treatment.
PUVA: A key treatment for psoriasis is PUVA which stands for psoralen (P) + ultraviolet A (UVA). A person is first
given psoralens (drugs containing chemicals that react with ultraviolet light) and then exposed to UVA light. This treatment
is very effective but elevates the risk of skin cancer. Why has not been known. New Finding: There is an increased
prevalence of the human papillomavirus (HPV) in hairs plucked from patients with psoriasis treated with PUVA. HPV is tumorigenic (it causes the
formation of tumors).
is an important new finding because psoriasis is common and PUVA is a key treatment for it. The idea is that PUVA promotes
skin cancer by increasing HPV in the skin. PUVA may do this by stimulating the replication of the virus or by
immune suppression, or both.
Amevive: Alefacept is an injectable drug that suppresses the
immune system and is used for the treatment of psoriasis. Scientists believe that psoriasis is caused by an increase in the production of one type of immune cell, T-lymphocytes, in response
to the attachment of a stimulant (antigen) to the lymphocyte. The stimulated T-lymphocytes cause skin cells to grow rapidly,
and the rapid growth of the skin cells produces the skin plaques of psoriasis.
Alefacept reduces the stimulation and production of T-lymphocytes by attaching to the site on the T-lymphocytes
where the antigen attaches. This prevents the antigen from binding and activating the T-lymphocytes. Alefacept also decreases
the life-span of T-lymphocytes that already have been produced by increasing the activity of another type of immune cell,
natural killer cells, that kill T-lymphocytes.
Alefacept was approved by the FDA in January, 2003.
Enbrel: ENBREL can dramatically reduce psoriasis symptoms
clearer skin, month after month. If you have psoriasis, a recent medical breakthrough could make this a reality for you, because
ENBREL has now been approved for the treatment of adult patients (18 years or older) with chronic moderate to severe plaque
psoriasis who are candidates for systemic therapy or phototherapy. Many people have seen dramatic improvements while taking
ENBREL, and it could make a big difference for you, too.
ENBREL can start working fast—and
ENBREL can help you stay clearer, month after month. In medical studies,
psoriasis patients saw significant results:
- 3 out of 4 psoriasis patients
who took ENBREL had at least a 50% improvement in skin symptoms after 3 months of treatment. What’s more, almost half
of the patients studied had at least a 75% improvement.
- Nearly half of the
psoriasis patients studied were determined to be clear or almost clear by 3 months (based on a five-point scale on which 0
= "clear" and 1 = "almost clear").
- Improvement was seen
in many psoriasis patients as early as 4 weeks.
Methotrexate: is a folic acid derivative and a folic acid antagonist. Methotrexate counteracts and competes
with folic acid in cells. This blocks DNA synthesis and stops the growth of rapidly dividing cells, causing cell death.
MTX works best on extensive psoriasis, erythrodermic and acute pustular psoriasis, physically disabling psoriasis
of the palms and soles, psoriasis in the elderly, and severe psoriatic arthritis.
The majority of patients achieve significant
or even complete clearing of their disease with MTX. The clearance or remission can last for a few weeks to a year or more
after stopping therapy.
MTX can be highly effective in reducing symptoms of psoriatic arthritis and arresting joint
destruction caused by certain forms of psoriatic arthritis.
MTX can be taken either by mouth or by injection. The most
common way people take MTX is by mouth, either as a pill or in a liquid form. The physician will gradually adjust the dose
to the smallest amount needed to achieve clearance. This minimizes the possibility of the patient experiencing side effects.
MTX is usually taken in a single dose once a week.
The physician will not increase the dose of MTX to achieve total
clearing (100 percent) if a few stubborn lesions remain. Instead, another therapy will generally be added, such as UVB, cortisones,
or anthralin, to clear the remaining lesions.
The physician will perform a number of tests, including kidney and liver
tests, to ensure the drug is safely metabolized by the body and is not adversely affecting the liver or bone marrow.
long-term MTX therapy is anticipated, the physician may require a needle biopsy of the liver. The biopsy may be given before
or after starting the drug and at intervals while the drug is taken.
The initial liver biopsy may be postponed for
several months after MTX therapy has begun. This is to avoid an unnecessary procedure in case MTX therapy is stopped for any
reason in a short period of time. Reasons for stopping MTX would include lack of patient response, unacceptable side effects,
or rapid response not requiring any additional drug.