Wednesday, February 27, 2013 Momorris asks

Q: What is "slightly active RA'?

I saw my rheumy for a 6 month follow up got a copy of my record and he notated 'sl active RA' but honestly didn't do a full exam as he usually does. (He was more focused on my hip pain which is 8/10 and my recent back surgery) He did ask me "What r we going to do about those hands"? And I said 'Those aren't my problem, the hip is". I am only on arava 10 mg and Mobic 7.5 mg once a day because I need my fusion to solidify as best as it can. Has anyone heard of these terms and where is a scale that measures activity of RA? Also has anyone used that new blood test that measures RA activity other than the standard tests? I would be considered sero-neg since do not elevate like my symptoms do. I look forward to all your expert answers! Thanks! Mo

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Answers (2)

V, Health Guide

3/ 2/13 8:39am

Hi, Mo!

Are you talking about the Vectra test? It is supposed to show what meds will help you the most, I believe. I have not had it. My rheumy doesn't think it is as accurate as she would like, so she uses the standard CRP, and SED rate. I am sero-negative, too. But my SED rate and CRP do get elevated. Not off the charts elevated, but she knows what is "normal" for me, so she watches those closely. For instance, after my first infusion of Orencia, my SED rate went from a 25 to 8. My CRP went from 7 to .9. I wish your RD would have done a full joint exam. How many joints would you say are inflammed at this point, and what is going on w/your hip? RA and OA perhaps? Bursitis? Sometimes those image-guided steroid injections can help hip bursitis a lot. I was at the point of having the bursa removed in my left hip when I first saw my current rheumy. She shook her head no, and told me the bursitis would get better when we got my RA better controlled. She was right!

Best Wishes!

Momorris

3/ 7/13 11:16am

Thanks V! I appreciate your input. He has been calling my hip pain bursitis since last spring and always offers an injection, but maybe he's thinking that the RA is inflamed causing the bursitis. I am just avoiding injections until after my 6 month mark of my fusion surgery. Yes, that Vectra test is exactly what I am talking about. Couldn't remember the name ! Has anyone used it? My RA doesn't show on labwork at all. My last sed rate was 6 or 8 but I was on pred and remicade. (Months ago) Thanks for your help! I knew you could tell me what's what! Mo xo

V, Health Guide

3/11/13 9:25pm

Hey, MO!

I know a few people who have had the Vectra test. They told me that their rheumies use it to see if the treatment they are on is working. My RD tells me the test is expensive and she is not impressed w/its accuracy. She goes on clinical symptoms...swelling, inflammatio, etc, and in my case CRP and SED rate since I am seronegative. I guess it just depends on the doc.

When you are on prednisone, it will lower your inflammtion markers. Also, if your meds are working, your inflammation makers should be lower. That is how my RD decides whether or not my med combo is working.

BTW, I am seeing my ortho this Wednesday to scheule hip injections...think I will do both at the same time. I have been suffering w/that bursitis for months now...ever since I had to stop Orencia for six weeks due to an infection...and I am tired of the pain. They do work for me. :)

Take care, MO. Happy to hear from you.

Momorris

3/11/13 9:57pm

V---good luck with your injections. They do work for me too! My rheumy goes more on symptoms too which I am grateful for! Thanks for all your input..I really appreciate it! Mo xo

Lene Andersen, Health Guide

3/14/13 1:43pm

Hi Mo! it's lovely to see you again!

Most rheumatologists use the ACR criteria for different levels of improvement. As well, I imagine that they also use their experience and compare the person in their office to other people in their practice who are at mild, moderate or severe levels of activity. Personally, I tend to rely a lot more on a good rheumatologist's experience than the usual blood tests. However, as you mentioned there is a new test on the market that measures biomarkers for RA and may be used to assess how treatment is working. It is recommended that is used to complement physical exam - it's not a replacement for an experienced rheumatologist.

If you're concerned about your response to medication, I'd recommend that you talk to your rheumatologist about options for beating down the RA to its proper place. Obviously, as you are in the process of healing from a fusion, you may have to wait a while before you bring out the big guns, but it might be a good idea to have a plan for when that happens.

Q: What is "slightly active RA'?

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