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!
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.
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