Anti_TNF Screening

mmarshall

Hi Everyone

I know this question has propably been asked loads of times before but I am not always on this site, so sorry if you have answered it loads of times before.
I have RA and having lots of problems just now with flare ups. I had to get a emergency appointment at the clinic by going to my doctor due to hardly being able to walk with the pain and swelling in my feet, along with other pains.
My Rheumy doc said that as I am already on meth, sulpha and hydroxy and it is not workin then next step is the Biological drugs.
I also have been getting the steriod jabs in the bum every 3 mths but they are not working as well as previously.
Rheumy doc took loads of blood, was sent for a chest Xray and given 2 leaflets to read, Rituximab and Etanercept and was told that I would hear soon when I was to come back to the hospital.
I got an appointment through for the 4th Oct to go to the Day Ward for a 1 hour anti TNF screening. What happens in this appointment, does this mean I am starting one of these drugs or is it just to go over apects about them.

Thanks

Mary

frogmorton

Hi Mary

l no very very little, but what l think is that they check you over for various things (maybe that TB is one of them) and that pending all of those being ok they will start you on one soon thereafter.

Someone who has 'been there' should happen along soon and tell you much more.

Glad at least that the ball is rolling for you.

Love

Toni xx

mmarshall

Toni

Thanks for your reply, it is good to know that you can ask questions on this site when you are not sure of things.

Mary

dorcas

Hi,
Sorry your arther is not responding to your current treatment... but hopefully you'll find that you get a good response from anti-tnf therapy.
It's along time since I went through the pre anti tnf checks but I'll try to remember.
I think it's likely that the appointment you have is to go over a number of checks with you prior to commencing the treatment. One of the things they ask you is about any prior TB treatment or family history of TB and if you have had a previous vaccination for TB (BCG).
You'll have an up to date chest X-ray (which you've already had ) and they may give you a clinical examination to make sure you have no infections.

When I had the checks done the doc also did a Heaf Test . A Heaf Test involves application of a small amount of a test substance called Tuberculin, into the outer skin layer of the arm by six sterile needle-points. The area on the arm is looked at one week later to assess what type of reaction has taken place.
Depending on the results you'll then start treatment!

I've probably forgotten something :roll: but I'm sure other folks will answer your post with more info!

good luck and I do hope the treatment helps you.

Iris xxx

ps... I think from being told I'd start anti-tnf to having the checks done ... to actually getting it was 7 weeks!

Ankyspond

Hi,

I am on Etanercept at the minute, started it in November and inject myself each week. Firstly it is very good for me (everyone different) I suffer no side effects and it controls the pain in my back and hips very well (I have AS), not so good on the knees, ankles etc so I am on Methotrexate as well.

All I can tell you is what happened with me, I had the bloods, x rays and had to go and have a chat and get the leaflets and be told about it. During that meeting I had to the basmi test where they measure everything and you answer lots of questions about the pain, I was then told I had to wait three months to see if it hadn't improved they would put me on it. I then got an appointment to go the day ward where I was shown how to do the injection and given some medication and a sharps bin. I had to stop in there for an hour or so to make sure there was no reaction, I went back for three weeks for them to see me doing the injection right and then they delivered them to my house and every three months you have to go back and the the basmi test done again. If your levels improve quite good they keep you on it, there is a certain amount it has to imporve by withing a certain time to stay on it. The imporvement in mine has been amazing.

The injections will be delivered to where you want but you will need to have a fridge to keep them cool. Just be careful in case you every have a power cut, also use ice where you gonna inject (alternative weeks in top of leg or tummy for me) for few minutes before and after will ease the reaction. If you get a reaction can take anti histimene tablets. I was told to always take on the same day but can move it one day either way if needed. If you go on holiday you will need to keep it cool, we drove to France and I put it in cold bag with lots of ice but you need letter from hosptial for airlines, ferries etc.

I hope this has enlightened you and I really hope it helps you let me know how you get on. xx

mmarshall

Dorcas and Ankspond

Thank you very much for all the info.
I would rather know what to expect than going in without any knowledge of what could happen.

I have really struggled this year with pain and swelling mostly in my feet making walking very difficult. Also a lot of eye problems, everytime I have a bad flare up I take ulcers in my eyes and it is very painfull.

I have managed to stay at work, although I have had lots of time off for hospital and doctor appointments. I work in a office and can do most of my work at my desk but I have been really struggling, as you all know how tierd and horrible Arthur makes us feel.

The people I work with are nice but after having this illness for over 3 years the sympathy is gone and I think sometimes they think "oh here she goes again moaning and she off again to another appointment".

To tell you the truth I don't care what they think anymore as I am the one that is struggling. I have worked in the same bank for over 38 years and allways had a good work record so I have nothing to feel bad about, it is not my choice to have RA.

So I am hoping that once I start the new treatment I can start to enjoy myself again instead of being down in the dumps about all the things I cannot do.

Did'nt mean to ramble on but I know you all know how I feel.

So fingers crossed that when I start the new treatment I will see an improvement.

Thanks everyone

Love Mary

tillytop

Hello Mary

I agree with the others about the screening appointment in that I think it is likely to be a "final check" before you start the meds. It should also give you an opportunity to ask an questions.

Not sure whether the choice of Etanercept or Rituximab is yours (sounds as if it might be since you were given leaflets on both) but just to make you aware, if you are not already, that Rituximab is not by any means a fast acting drug and can, apparently take up to 9 months to really "do its stuff" if it's going to. I had my first two Rituximab infusions just over three months ago and I feel that it is certainly helping already (although I don't think my rheumatologist believes me :roll:) I believe that Etanercept is potentially quicker to act.

Hope it all goes well for you - and that the new drugs help you.

Tilly xxx