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Answers tagged rheumatoid arthritis: Page 5 of 5
Q:

Gwen from Edmonton asks:  I was diagnosed with fibromyalgia rheumatica 4 years ago….took prednisone ….tapered very slowly off this summer…….now all the symptoms are back…..how long does this disease last?

It is common to confuse fibromyalgia and polymyalgia rheumatica (PMR) – the first is a condition associated with chronic pain and can be treated with a number of non-pharmacologic options, while PMR requires low dose prednisone for approximately one year.  In most cases of PMR, a slow titrating course of prednisone is effective, although there are times when symptoms return.  For these cases, retreatment with prednisone, or the addition of steroid sparing medications, is considered.  Equally important is to review your symptoms with your physician to ensure the correct diagnosis, or change in diagnosis.

Q:

Julia from Edmonton asks: What tests are done to confirm RA? Is it possible to have normal blood labs and still have this disease?

There is no test that confirms a diagnosis of rheumatoid arthritis. Your story and an appropriate physical exam by your rheumatologist is the best way to make a diagnosis. To answer your question, it is very possible and common to have completely normal blood tests and still have rheumatoid arthritis.

Q:

Carolina from Calgary asks: My husband has AS and may be starting a TNF blocker. We were told once he starts it, he will be on it for life, even if he goes into complete remission because the worst thing to do with biologics is to start and stop them since it may increase immunity to it. So, if after a while he is free of symptoms, can he to try to wean off the med or does he have to take it for the rest of his life?

Assuming a good response to a biologic for ankylosing spondylitis or rheumatoid arthritis, one can always try to see if the disease will remain under control off medication, be it a biologic or traditional DMARD. There is a risk of the disease flaring of course, and there is a risk of not having as a good a response to the same medications a second time. However, many patients do this and most do not have problems restarting their medications again.

Q:

Chris from Sherwood Park asks: I am taking methotrexate injections. folic acid and Humira for my RA. I seem to be getting many more canker sores lately. Is there anything else I can do besides taking the folic acid to prevent them?

Mouth sores can be a side effect from methotrexate and one you should discuss with your rheumatologist to determine the best way at treating them. Options include increasing the dose of folic acid, decreasing the methotrexate, or replacing folic acid with folinic acid. The choice is unique to each patient’s situation and should be discussed with your doctor.

Q:

Michelle from Sunny Island Beach asks: I have RA and Lupus and have been taking Methotrexate and Plaquenil in combination with rituximab. My insurance will no longer cover Rituxan but it will cover Humira or Enbrel. Is it possible to replace rituximab with a TNF blocker? My doctor told me I can’t “step down” from rituximab to another medication.

For rheumatoid arthritis, there is no clear evidence to suggest any biologic when used under optimal conditions is better than another. A patient would never be stepping down between different biologics, just switching. However, patients with lupus do need to be cautious with TNF blockers as they can exacerbate their disease. Rituximab is considered safer for lupus patients.

Q:

Lynne from Edmonton asks: Could you please discuss the link between RA and Fibromyalgia? I have been diagnosed with RA but at times my whole body hurts…just wondering if that might be what I have..

Up to one-third of patients with rheumatoid arthritis may also develop fibromyalgia. As the rheumatoid arthritis gets under better control, your sleep will improve as will your ability to be more active; this should lead to improvement in the more diffuse pain from the fibromyalgia too.



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