Are TNF Blockers not an option for RA patients also positive for ANA's?
I was diagnosed officially this February with seropositive RA. I am also ANA positive. Because of the latter, my Rheumatologist says that I am not a candidate for the TNF blockers and that Rituxin and Orencia are my only current choices. She said that the TNF blockers could throw me into full-blown Lupus. It is not that I don't trust my doctor, I just know that she is of a more conservative mind set when it comes to treatment (finding damage on x-rays before moving to a stronger treatment, whereas, the rest of the community seems to be steering towards preventing that damage from occuring). I am just curious to hear another opinion. I have been on Methotrexate, Plaquenil, Celebrex and Folic acid for about 9 months and I am still in pain (haven't had a full flare with fatique, etc., since I started the meds though).
Also, I know that I have seen others mention this here, but really - can Methrotrexate cause weight gain because I have literally gained 20 pounds since starting it and mostly around my middle?
Thank you!
Liz
Hi Liz,
I don't think I can answer all your questions, but I'm interested in finding out what you find out ... I'm on Enbrel, I was ANA negative when I started and now I'm ANA "speckled" which is to say, something like borderline positive. So the ANA antibodies I guess can develop along the way. Sounds like your doctor is being extremely cautious. But I have also heard that drug-induced lupus goes away when the drug is stopped, so I'm a little surprised that there would be so much worry. But maybe your ANA is high enough to worry about causing you those problems (it would definitely be scary) and he just wants to find the best, right treatment for you.
I've never taken MTX but I think I've read from others that in some people it may cause weight gain (maybe from feeling so lousy, and fatigued that the weight comes on?) Hopefully, you'll hear from others who can answer your questions better.
-
- Ranked Helpful (1)
- Report Abuse
Liz M.
Tuesday, November 24, 2009 at 08:27 PM
Ellen
Tuesday, November 24, 2009 at 09:42 PM
I'm not familiar with the ds-DNA stuff - I just looked it up now and I think you are referring to anti-doublestranded DNA antibodies that are associated with Lupus ? (Dna is supposed to be double-stranded, - it's the antibodies that aren't supposed to be there...sorry for my confusion!)
So, you are way ahead of any knowledge I have about lupus ... I wish you luck!
To be honest, I haven't heard before that TNF blockers should be avoided when you are ANA positive. However, I'm not a doctor and obviously not up to date on all the rheumatology research. However, the fact that your doctor is so conservative that she waits until there's damage on an x-ray before initiating treatment concerns me. You're right - the prevailing thinking within the field these days is to prevent damage from occurring by early and aggressive treatment and by the time joint damage is visible on x-rays, you can have quite a bit of damage. This alone makes me question her other statements - whether that's fair or not is a conversation for another day - and leads me to recommend that you get a second opinion. This is your body and your future and if your doctor is not up on the latest in the field, you need to find somebody who is in order to protect your future mobility.
- Thank you for your input
- Ranked Helpful (1)
- Report Abuse
Thank you for the response, Ellen. I think the concern is that sense the TNF Blockers can cause double stranded DNA and I already have it, then it could put me into full fledged Lupus - that wouldn't just stop with stopping the meds (like triggering it). I am hoping the new doc I switch to when I move will have a more detailed explanation for me.