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Medications & Treatments For discussing medications and all treatment methods

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  #1  
Old 04-15-2012, 10:38 AM
Sohllee Sohllee is offline
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Medicating MS and RA

Hi. I am 55 years old and have been on Rebif for the past 7 years since I was diagnosed with MS, and it has been working well. Almost a year ago, I was also diagnosed with RA. My rheumatologist put me on Methotrexate, because that was one of the few medications that was compatible with the Rebif. My liver function was somewhat elevated when I was just on the Rebif, but it has been climbing higher. I have an appointment with a liver specialist, but for now my doctor wants me off the Methotrexate. His other suggestion was Riduxin, which scares the heck out of me. I'm his only patient with both MS and RA, so I was wondering if anyone has had similar issues, and if so, what they did about it. Thanks!
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  #2  
Old 04-15-2012, 06:48 PM
Redwings Redwings is offline
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Hi Sohllee:
There are several people who post here who have RA and MS. Hopefully they'll post to share their experiences with medications.

I'll take this opportunity to comment on some of the technical stuff. There's a bit more to choosing a medication for RA in your situation than finding one that's compatible with Rebif. The meds used for RA are all heavy-duty immune meds, so caution has to be used when mixing any of them with each other and with Rebif. As as example of that, combining two meds that are known to be harmful to the liver can cause problems, as you've found with mixing Rebif and methotrexate. So, in that respect, an argument can be made about how compatible they really are.

Another aspect of finding a med to treat RA is that the TNF inhibitors aren't compatible with [I]MS[/I] (which is different than not being compatible with Rebif). Unfortunately, that takes several effective RA meds out of consideration for you.

Rituxan has had some good, though not great, results in small trials for MS. (The fact that MS researchers haven't gone gung-ho for it says something.) It's also being used for RA. So as far as treating both conditions, it's a possibility. (It most likely would be used instead of Rebif, not in addition to.)

Cellcept is also being used by some neurologists to treat MS. It's also used to treat RA, so it's another possibility for you. (It most likely would be used instead of Rebif, not in addition to.)

Cyclosporine and azathioprine are immunosuppressants sometimes used to treat RA. They were tried in the past for MS. They weren't particularly helpful for MS, but weren't found to be specifically harmful for it, either. So they're possibilities. Cyclosporine is metabolized by the kidneys, so it might give your liver a break.

There's another med to talk to your rheumatologist and neurologist about, and it's a bit of a stretch. The active ingredient in the RA med Arava is leflunamide. Leflunamide is the prodrug form of teriflunamide. That's relevant because teriflunamide has shown good results in trials for MS. There isn't good information available about whether leflunamide itself is helpful in MS, but it could be worth looking into.

Rituxan is a little scary, but [I]all[/I] of the immune suppressing meds are scary. Even methotrexate is scary. Heck, even Rebif is scary. So there are really two sides to the question. One side is what might happen if you [I]do[/I] go on another one of the RA drugs. The other side is what might happen if you [I]don't[/I]. That isn't an easy balance to reach, and sometimes none of the choices are good.

You didn't say whether you've tried it before, but another possible choice for you is to switch your MS med to Copaxone. It works differently in the immune system than do the interferons. It isn't particularly known for causing liver toxicity and [I]might[/I] be more compatible with other meds used for RA.

I appreciate that you're at a disadvantage with being the only patient of your rheumatologist who also has MS. Do you know if your rheumy has consulted with other docs who are more experienced in treating patients with both?
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Old 04-16-2012, 10:08 PM
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WendyRochet WendyRochet is offline
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MS and RA?

Quote:
Originally Posted by Sohllee View Post
Hi. I am 55 years old and have been on Rebif for the past 7 years since I was diagnosed with MS, and it has been working well. Almost a year ago, I was also diagnosed with RA. My rheumatologist put me on Methotrexate, because that was one of the few medications that was compatible with the Rebif. My liver function was somewhat elevated when I was just on the Rebif, but it has been climbing higher. I have an appointment with a liver specialist, but for now my doctor wants me off the Methotrexate. His other suggestion was Riduxin, which scares the heck out of me. I'm his only patient with both MS and RA, so I was wondering if anyone has had similar issues, and if so, what they did about it. Thanks!
Im just 39 was dx MS on my 37th bday! been on rebif ever since then and started having severe joint pain, also developed Raynauds syndrome badly....

drs do not want me to stop the rebif but im not sure what to do, the rhuemotologist says i was neg RA in my bloodwork a 10? but my grandmother had RA and im scared it will develope. also thyroid is off now and Im anemic? my family has a bad history of hypothyroid im just curious if the rebif is causing all this to speed up in my system. before MS I was an extremly healthy very physically fit person, now i fell like im on an MS drug indused rollercoaster ride
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Old 04-17-2012, 08:50 AM
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Flug Flug is offline
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Hi Wendy, I have RA too but I had RA before MS . I don't know alot about Rebif but when I was researching what medications to take for MS I think I avoided that one because of the large list of side effects . If it was me and I didn't have RA before I would wonder if it is the medication and switch to another one , I'm currently taking copaxone and I haven't had any side effect except some site soreness.

I am still looking how to treat my RA, I am in pain daily from it , I even went to see a MS specialist at a university and they were no help because they didn't have a patient that had both. Redwings has made some good suggestions and I am going to explore it with my Dr.s here at home . Good luck and hope you figure this out
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  #5  
Old 04-19-2012, 09:17 AM
knuckle knuckle is offline
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You may want to watch this presentation:

Dr. Burt Berkson Presentation on LDN and Alpha Lipoic Acid Therapy for Cancer & Autoimmune Disease

http://glasgowldn2009.com/2009/04/ld...erence-video3/

Dr. Berkson has had great success treating RA patients and he discusses it at length in the second half of the lecture (the first half is on cancer).
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  #6  
Old 04-23-2012, 02:53 PM
Sohllee Sohllee is offline
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Thanks, everybody! You give me lots of food for thought, and I'm meeting with my neurologist this week - I don't know what her take on all this is.
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  #7  
Old 06-06-2012, 06:47 PM
Amer1br1t39 Amer1br1t39 is offline
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Sohllee Ive been taking rebif for 4 months now and about to start taking methotrexate next week for psoriasis, I'm kinda scared mixing the two drugs but have stressed to my neuro and dermo if this is safe? I know both are bad on my liver and they said it will be ok? My question is how will it affect me? I know MTX is basically chemo and I'm afraid that I wouldn't be able to do my job...:-( I work 6 sometimes 7 days a week and 10 hrs a day..praying that I can still keep to my work schedule and that I don't get too sick..:-(
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Old 06-07-2012, 12:01 AM
Redwings Redwings is offline
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Quote:
Originally Posted by Amer1br1t39 View Post
Ive been taking rebif for 4 months now and about to start taking methotrexate next week for psoriasis, I'm kinda scared mixing the two drugs but have stressed to my neuro and dermo if this is safe? I know both are bad on my liver and they said it will be ok?
Hi Amer:
Of course each specialist wants you on a med to cover what they're treating you for. You're wise to recognize the possibility of liver trouble from mixing the two meds. Your liver might be fine on both meds, it might not. There isn't any possible way for your docs to know in advance whether or not taking both meds together will be OK. Some people do great on both meds, individually or together, and some people (like me) can't tolerate even the smallest dose of methotrexate.

The only way you and your doctors are going to know how you do on methotrexate (or the combo of Rebif and methotrexate) is for you to try it. However -- speaking from both medical knowledge and personal experience -- it's in your best interest to insist on regular liver function tests (a minimum of monthly) for at least the first six months. It's your doctors' job to monitor you, so don't let them take any shortcuts by telling you everything will be OK without actually testing to prove that that's so.
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