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Answers tagged rheumatoid arthritis: Page 1 of 5
Q:

Jeanine from Sylvan Lake asks: Are cataracts associated with rheumatoid arthritis?

Rheumatoid arthritis can have a number of manifestations within the eyes, including scleritis, sicca symptoms (dryness), or even vasculitis.  While not as common, cataracts can occur, although this may be more due to steroid use (e.g. prednisone) than the arthritis itself.  Cataracts itself is also relatively common in the general population: those aged between 40-50 have a 5% rate of developing cataracts, so it is possible to coincidently have both.  The most important thing to do from an arthritis point of view is to ensure your arthritis is under good control.  If you have no inflammation, the chance the arthritis is affecting your eyes is low.

Q:

Ammar from Alberta asks: Biologics are expensive!  How do I make sure the cost is covered?

Biologics are expensive!  They can range from $10,000 to $25,000 per year.  No one can afford that, which is why having insurance coverage for these medications is important.  Most insurance plans have rules which must be followed to have these medications covered.  Most of these rules are reasonable.  For instance, for rheumatology problems, biologics must be prescribed by a rheumatologist.  You must have a disease that we know is treatable by a biologic.  You must have tried other medications first which we know may work as well (e.g. methotrexate) before trying a biologic.  And finally, we must show that the condition has improved on a biologic.  Working with your rheumatologist, there is nearly always a solution to finding funding for biologics.  If you are having troubles, make sure your rheumatologist knows.

Q:

Mona from Calgary asks: I don’t see anything about Rinvoq.  My rheumatologist has suggested that one for me.

Rinvoq, otherwise known as Upadacitinib, is part of a newer class of advanced disease modifying medications for inflammatory arthritis called JAK Kinase inhibitors.  To learn more about it and the other JAK Kinase inhibitors that are currently available, visit our webpage here.

Q:

Emma from Canada asks: I received my 2 doses of the Moderna vaccine and with the first experienced a 1 week rheumatoid arthritis flare but it was manageable. After the 2nd dose, my RA took a turn for the worst & I have been in the worst flare of my life since (4 months now).  Should I still get the booster?

The best advice for anyone in this situation is to speak with your rheumatologist.  Regardless of the vaccine, a flare lasting more than a few weeks deserves a conversation with your rheumatologist to determine the best course of action going forward to get it under better control.  That said, while there is some evidence that the COVID vaccine may induce flares in a small minority of cases, most times the flare is either a side effect of the vaccine but perceived as a flare (likely what is described after the first shot) or a coincidence of association, rather than causation.  As so many people are getting COVID vaccine, it will happen that some will flare afterwards, but it is likely that many of those flares would have happened anyways.  As a general principle, 3rd (and now 4th) shots for COVID vaccine are encouraged for those with rheumatic diseases.

Q:

Erin from Jasper asks: My dentist diagnosed me with rheumatoid arthritis based on findings in my TMJ joint.  What should I do now?

Rheumatoid arthritis is a systemic disease and whether or not it impacts one joint or many, it should be ideally managed by a rheumatologist.  Rheumatoid arthritis is a condition that can be placed into remission with the right treatment.  If not already, you should speak to your family physician or dentist about a referral to a rheumatologist to ensure there are no other joints involved and treatment options are discussed.  In Alberta, all rheumatologists require a referral.

Q:

Norma from Alberta asks: I have stable lupus.  Can I get the COVID-19 vaccine?

Please visit our COVID-19 vaccine information page, which we will keep updating as more information becomes available.  At this time (January/2021), there is no information to suggest the currently available COVID-19 vaccines are unsafe for those with lupus or taking any medications for lupus.  That applies to all rheumatic conditions, in fact. If you are still not sure after reading the available information, please contact your rheumatologist.

Q:

Lily from Edmonton asks: Is there a generic version of Enbrel or Etanercept that will do the same thing Enbrel does for less cost?  I can’t get Enbrel covered anymore.

Biosimilars are new medications which are biologically similar to original biologics.  In Canada, as of 2020, Enbrel and Remicade both have biosimilars available and many medication insurance plans are, or are considering, not providing coverage to the original biologic, but rather the less expensive biosimilar.  For most patients, the biosimilar should be as effective and safe.  However, for each individual, it is important to speak with your rheumatologist to make the right decision for you.  For more information on biosimilars, please click here.

Q:

Austin from Toronto asks: I tested CCP positive but have no symptoms of rheumatoid arthritis.  Am I more likely to get it now?

Anti cyclic citrullinated peptide (anti CCP) is a test which is highly associated with rheumatoid arthritis.  It is not necessary to test positive to have rheumatoid arthritis, but most individuals who are positive have or will develop RA.  That being said, there are exceptions to this rule, particularly if the test is not strongly positive.  In particular, there is growing data to suggest individuals with pulmonary (lung) issues may test positive and not develop RA.  In some instances, it may be worthwhile monitoring your joints with a rheumatologist over time to ensure you do not develop rheumatoid arthritis.

Q:

Richard form Montreal asks: Is Xeljanz (tofacitinib) covered in Alberta?

Every province has slightly different rules for coverage of advanced therapies such as tofacinitib, and biologics.  That said, in most situations, working with your current rheumatologist, or your new rheumatologist if you are planning a move to Alberta, a solution is found to ensure you can continue to receive the treatment that makes you well.

Q:

Tracey from Canada asks: If I have psoriatic arthritis, can I work as a gas bar attendant?

The treatment goal for any inflammatory arthritis is to reach remission.  Those in remission should be able to participate in all their normal activities, including work.  Before reaching remission, patients should listen to their bodies.  If it hurts when you are doing something, it is important not to ignore that.  However, that line of what is too much is going to be different for everyone.  The important thing to know is that being active is not going to make the underlying disease worse.  In fact, exercise in moderation is considered a positive step for those with inflammatory arthritis.



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