In the lead up to each remicade infusion I look closely for any arthritis symptoms. Sure I am aware that my psoriasis gets worse before my infusion is due, however I’m unsure whether there is any hint of arthritis peaking through. I know my lower back pain and ribs get very sore before I have my remicade and have blogged about this – however I don’t see any signs of sausage fingers which I used to get quite severely in my right hand before I started on biologics.
The reason I look for arthritis symptoms is because in the back of my mind I have a little “what if” itch. The itch is “what if I ever have to change my job?” Why is changing my job important? Because my current employer covers the cost of my remicade and there is no guarantee that any future employer would be so accommodating. To any non-biologic-taking people out there, you may be wondering why this could be a big deal. Well, the cost of my remicade infusion is currently around 150K baht for each dose. That is around USD$4,900. So my annual cost of remicade comes in at close to USD$20K. Basically I could not afford to cover that cost myself.
So I look for arthritis symptoms wondering if the remicade has pushed it into remission, and that the arthritis may not return if remicade was stopped. “Does this happen”? I hear you ask. Well, maybe only the people with PsA and on biologics are asking! Well, I’m not sure. However recently a scientific paper was released regarding patients with inflammatory bowel disease taking remicade:
A recent study was published showing that patients that were in remission as a result of infliximab and immunosuppressive therapy (no steroids) had a 50 percent chance of relapsing within a year after ending the treatment.
That is, patients with IBD (which like PsA is a result of an overactive immune system) who are taking remicade, can go into remission. Further, it seems that 50% maintain that remission for more than a year. Would the same hold true for PsA? I’d like to see some studies.
Am I likely to stop taking remicade to see if I’m in remission? No way! Apparently if one is on a biologic and stop taking if for a period, and then start up again there is no guarantee that it will work anymore. Apparently 30% of people with IBD who stop remicade will fail to have any response if they start again. However it depends on how well the remicade worked for you in the first place. The better the response you had then the more likely it will work again after taking a break.
I got all this wonderful information from Dr. Karen’s colitis blog here. Well worth the read.