Advice about anti-tnfs

marion1952
marion1952 Member Posts: 963
edited 28. Jul 2010, 10:42 in Living with Arthritis archive
Hi folks

A few things I am unclear about with regards to anti-tnfs:-

1. How much methotrexate do you take with an anti-tnf? Do you remain on your current standard dose (in my case this is 15 mgs) or do you go on a low dose (say 7.5)?

2. So far (2 years) I have not had a chest infection whilst on methotrexate. Does adding an anti-tnf lmean always mean a higher risk of developing infections (chest or other infections)?

3.If you have had the pneumonia vaccination does this mean you would not get pneumonia even on anti-tnf + methotrexte??

Sorry - i haven't expressed myself very well here and am struggling with sore hands today, but hope you understand my queries..


Thanks

Marion

Comments

  • scattered
    scattered Member Posts: 326
    edited 30. Nov -1, 00:00
    marion1952 wrote:
    Hi folks

    A few things I am unclear about with regards to anti-tnfs:-

    1. How much methotrexate do you take with an anti-tnf? Do you remain on your current standard dose (in my case this is 15 mgs) or do you go on a low dose (say 7.5)?

    2. So far (2 years) I have not had a chest infection whilst on methotrexate. Does adding an anti-tnf lmean always mean a higher risk of developing infections (chest or other infections)?

    3.If you have had the pneumonia vaccination does this mean you would not get pneumonia even on anti-tnf + methotrexte??

    Sorry - i haven't expressed myself very well here and am struggling with sore hands today, but hope you understand my queries..


    Thanks

    Marion

    Hi Marion,

    Firstly, you take much MTX as you can tolerate. If your dose now is 15mg it is unlikely to change. Once your established on therapy and have had a good response I suppose they might look at taking the dose down.

    The Anti-TNF targets different cells to the other immunosuppresants, so your ability to fight infection with those cells will be compromised. Ultimately I guess that would mean that your ability to fight infection does decrease further. Once you're on an anti-TNF you can't eat certain foods because of the risk of infection.

    I would hope the pneumonia vaccination would mean that you would be unlikely to get pneumonia while on either MXT or an anti-TNF. I do know that it is recommended, as is the yearly non-live flu vaccine

    All of the above taken into account: I've been on a cocktail of an anti-TNF, two immunosupressing DMARDs and steroids for 2 years and have yet to get a serious infection (touch wood). If I get a cold it takes a little longer to clear up than normal. I get my yearly flu shot and I've had the pneumonia shot. I'm careful not eat the foods I shouldn't (despite loving most of them!) and try to keep away from people who are ill. I always think that if RA means my immune system is over active maybe all the medication is just dampening it down to normal levels and that is why I don't seem to be prone to infections.

    I hope your hands feel better soon.
    Scat.
  • dreamdaisy
    dreamdaisy Member Posts: 31,520
    edited 30. Nov -1, 00:00
    I can't add to that, scattered has covered it beautifully. My dose of 17.5 meth has remained. The foods to avoid are soft cheeses (which may not be pasturised and include Brie, my favourite) and meat pate (can't do the circumflex, sorry). Not much of a sacrifice really! I too have the yearly flu jab, but I have no idea whether I've had the pneumonia one. I have steered clear of any major infection so far, but have had a couple of boils in a nasty place. DD
  • dorcas
    dorcas Member Posts: 3,515
    edited 30. Nov -1, 00:00
    Hi Marion :D

    sorry your hands are giving you so much pain today :( Is the hot wax not helping to soothe them or are you having a flare of arther and they're just too sore and swollen ?. :|
    I know using crutches since your hip op has put so much added pressure on your hands....wish there was something else to suggest....do you use ice packs or tried alternate hot and cold 'dipping'? I've never tried that combo but know others who find it helpful. Hope you get some relief Marion, especially as you're planning a return to work. :wink:

    Oh....I agree with everything scattered said. My Mtx stayed the same at 15mgs inj with 40mg Humira inj throughout the 4 years I was on that combination and I expect it'll stay the same when I start infliximab. Anti tnfs apparently are more effective with Mtx.

    Iris xx

    soothing ((((hugs)))) for your hands too. xxx
  • marion1952
    marion1952 Member Posts: 963
    edited 30. Nov -1, 00:00
    Thanks folks - that's helpful..

    My own fault about my hands Iris... I went to bed early night last night and tried to re-read my favourite book ' The Kite Runner' in bed ... and at 4 00 am this morning I was still reading it, despite my hands hurting from holding the book - so got up and used the wax treatment and put the book back on the bookshelf .. knuckles are now like huge marbles and hands feel like been squashed by a steam roller (you know the feeling)... not got median or ulnar nerve pain though, so am hoping will settle down in a few days ....

    So - sitting at the computer with my dressing gown still on and my 'bed head' still on ... lovely sight (not)...

    Marion x
  • dorcas
    dorcas Member Posts: 3,515
    edited 30. Nov -1, 00:00
    That's such a great book Marion...not surprised you couldn't put it down :wink: but oh we do suffer for our little indulgences. :roll:

    Just you stay in your PJs and dressing gown :!: a duvet day is what's required and you can avoid looking in mirrors for today!! resting is always good for inflamed joints.... have you topped up your pain meds :?: at least they may help take the edge off the pain.

    I know exactly how you feel Marion...it is murder having such sore hands; affects everything you do.

    don't type too much...although I know it's always good being on the forum chatting. or maybe you are also an expert typing with one finger of each hand :?:

    love n more (((hugs)))

    Iris xx who hopes you'll soon feel better.