Rheumatology Research News

The American College of Rheumatology recently held their annual scientific meeting. All of the abstracts from research are available online.

Lots of articles have been in the press recently with short snippets of information from the meeting. Notably, several new biologic drugs are showing promise in clinical trials, including two that have been specifically targeted at Psoriatic arthritis: Golimumab and Ustekinumab. The former is another TNF-alpha inhibitor (like Remicade, Enbrel and Humira). The latter is the first interleukin 12/23 inhibitor to show promise in the treatment of Psoriatic Arthritis.

Golimumab has also been in trials for Ankylosing Spondylitis.

It's nice to see the less common rheumatic diseases being targeted in clinical trials as opposed to getting drugs that worked for rheumatoid arthritis applied as afterthoughts.

Remicade FAQ

I've learned some more about Remicade and heard some questions from others. I'm sure that this information could be useful to someone currently taking or considering taking Remicade. This is not a complete guide to Remicade and is not medical advice. I offer this information as a service to others considering or currently undergoing Remicade treatment. For full information about Remicade and other treatment options, talk to your doctor or pharmacist and read the prescribing information.

Q. What is Remicade?
A. Remicade is a biologic response modifier (specifically a Tumor Necrosis Factor Alpha, TNF-alpha, inhibitor) used to treat autoimmune diseases. Currently it is FDA approved for the treatment of Rheumatoid Arthritis, Psoriatic Arthritis, Ankylosing Spondylitis, Chron's Disease, Ulcerative Colitis and severe plaque Psoriasis.

Q. How do you take it?
A. Remicade is given my intravenous infusion in a doctor's office, clinic, hospital or home health care setting. Infusions last anywhere from 1 to 4 hours. IVs aren't all that bad. Even if you don't have "good" veins, I've found that most infusion nurses are really good or know lots of tricks to make bad veins show up or both.

Q. How often do you take it?
A. An initial "ramp up" phase begins with infusions at weeks 0, 2 and 4. After that point, the typical interval is every 8 weeks. The dosing intervals are flexible, however. Some patients get infusions as often as every 4 weeks.

Q. How soon will I feel it working?
A. Improvement varies from person to person. Some people feel the effects immediately. For others it may take a few weeks, especially during the initial loading doses.

Q. What's with the dosages? I've heard it as 3 mg/kg and as 200 mg. Which is right?
A. Both. The recommended starting dosage for Remicade in Rheumatoid Arthritis is 3 mg/kg (for AS, PsA and psoriasis it is 5 mg/kg). Meaning, for every kilogram of your body weight, you receive 3 mg of Remicade. So, a person weighing 150 lbs weighs 68 kg. They would get 68 kg x 3 mg/kg = 204 mg. Usually doctors will use standard vials (100 mg each) for dosages, so they will round up or down. In this case, a 150 lb patient would most likely receive 200 mg or ~3 mg/kg.

Q. What is the maximum dosage?
A. 10 mg/kg is the maximum dosage. As stated above, the total mg dosage will vary depending on your weight.

LOLcat President

Description: Picture of a cat on the White House briefing room podium. Behind the cat is a White House seal on the wall. The text "this not so bad" is printed across the top of the page.

picture from I Can Has Cheez Burger

Reconciling faith, belief and a life of illness

Most of the time, life is pretty normal. Things go on, albeit at times painfully, and the reality of living a life of with a chronic illness does not have as profound an effect as our healthier counterparts may think. But, there are times when, like it or not, the brutal reality of things comes back into focus.

The stages of grief have been noted in those diagnosed with chronic illness. A grieving process over the might have beens seems perfectly normal when at least some of your hopes and assumptions about the rest of your life go down the drain along with a diagnosis. This is normal--the new normal of your life.

I get by pretty well in my day to day life. Yeah, I may do some things differently or more slowly than others, but that's fine. I try not to think too much about future possibilities or worry too much about what tomorrow will be like. I work, eat, sleep, play. I also pray and meditate and go to church. I try to have faith that somehow what has happened in my life has a purpose.

Yet, there are those who see my life and my health as an exhibition in my lack of faith or belief. They say, "If you believe, your body will get better". If you were just more faithful to God. If you just prayed more. If you really believed, God would heal you. This person will lay hands on you, and you will be better (yes, this really happened, though in a more extreme form--think lay exorcism). If you repented your sins, you would get better.

Those are the things that hurt most. I did not ask for arthritis. I did not let Satan into my life and into my joints (sounds a little silly, doesn't it?). I do get angry sometimes. I get upset. I ask God, "Why me?". But even Job, God's faithful servant, questioned the events in his life.

Job lost everything: health, family, earthly posessions. His friends blamed him for his misfortune. He questioned God and asked why. He didn't curse God, but he still felt the pain and raw emotion of a life less than normal. Job was rewarded for his faith. I have faith that I will be too, though perhaps not with good or restored health. I don't know God's will, but neither do they.

I have faith that I will survive. I will have a full life. I am blessed, and I will be blessed. I will have pain, but what life is without it? I am no less human or Christian because of my chronic illness. I challenge those who see illness as an expression of poor faith and/or sin to reconsider that belief (perhaps study Job). And then, consider how you and your faith community treat those who are chronically ill or disabled.

Book on Psoriatic Arthritis coming out soon

100 Questions and Answers About Psoriatic Arthritis, by Dr. Campion Quinn (via Matt & That) is a new book--finally(!)--with information about PsA.

I haven't read the book yet, and from what I can tell, it isn't even available for order yet. But, I'm glad to see we finally get a book. More resources can only be good.

This explains a lot...

According to a survey conducted by the First Amendment Center :

Sixty-five percent of Americans believe that the nation's founders intended the U.S. to be a Christian nation and 55% believe that the Constitution establishes a Christian nation

(emphasis mine)

Other gems from the poll:

• "Just 56% believe that the freedom to worship as one chooses extends to all religious groups, regardless of how extreme — down 16 points from 72% in 2000."


• "25% said 'the First Amendment goes too far in the rights it guarantees'"

This all hits close to home due to recent events in my community. A small Ismaili congregation wanted to build a jamatkhana in our neighborhood. The outpouring of filth from my neighbors was disturbing, even for a suburban city deep in the Bible Belt. At zoning hearings and other events, large numbers (150, I believe was the record) of residents would show up to protest the possibility of such a facility being built in the city. I can guarantee if a Christian church had proposed building their facility there, no one would have said a word. It's ok to be Christian, but it's not ok to be anything else. And that saddens me.

Oh, and to all the people who think the founders meant for the USA to be a Christian nation. Please, study history. Many of the people who first came to this country came for (gasp!) religious freedom. They didn't want to be part of the Church of England, so they left. Many of the founding fathers weren't Christian in the current evangelical Christian view (Thomas Jefferson, for example).

Now, the people who think the Constitution establishes a Christian nation. Please, for the love of God, read the freaking Constitution. There's this thing called separation of church and state. If a church or official religious organization gets involved in politics, they can lose their IRS non-profit status or be fined. All because of that principle.

When did people get so dumb?

I am bored, but...

The internets say I am a Nerd God. Though I am surprised how high my score was for Science/Math (not my best subjects by any means).