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Medical Forum / Diseases and Disorders / Arthritis / June 2005Remicade fade
Has anyone had Remicade stop working? I started on it a few years back (for RA) and was doing extremely well, but in the last few weeks all the old symptoms started coming back--first the exhausted flu-like feeling and then joint swelling, especially in some fingers. I had another infusion on Thursday and it did nothing. I'll call my rheumatologist next week, but I'd appreciate hearing from others whether they've had this problem, and if they did whether it was a temporary problem or whether they had to switch to different medications. Thanks, J i've definitely had remicade fade over time. in the beginning, 3 mg/k body weight worked wonders. i've had to increase every 6months-year since then. i'm at 8mg/k now. when that starts fading, it will be time for something else. your doc can increase your dosage up to 10 mg/k, or he can space your infusions closer together. good luck, diane After about 4 mos, started having to have increased dosages at shorter intervals as RA sympotoms turned worse. Doc did a check and found that remicade had turned on me and was making the RA situation worse with each infusion. Needless to say, we quit remicade immediately and are switching to Enbrel to see how/if that works differently. In your case it may be "remicade-turn" instead of "remicade-fade." > Has anyone had Remicade stop working? I started on it a few years > back (for RA) and was doing extremely well, but in the last few weeks all [quoted text clipped - 9 lines] > Thanks, > J Me. My RD has added one series of Rituxan and now we wait. Said it will take three to four months to see an improvement. But it allows me to continue Remicade. I am also on Arava. Are you on MTX with your Remicade? If so maybe you need to boost that dosage. Also, with Remicade I went from 3mg per kg of body weight every 8 weeks to 5mg per kg of body weight every 6 weeks. First we tried the dose increase and then moved the dosage closer together. Have you tried any of that yet? I think DianeC is on 7mg per kg of body weight with an 8 week recall. Duckie > Has anyone had Remicade stop working? I started on it a few years > back (for RA) and was doing extremely well, but in the last few weeks all [quoted text clipped - 8 lines] > Thanks, > J  Signature_('> (_<_) _ _('< -quack (_<_) _ __('< *QUACK!* <_{__) _('< "|,,|_" (_<_) _('< "AFLAC!" (_<_) I'm on MTX with the Remicade but had to switch back to pills because of the shortage (or maybe it's really the discontinuation?) of the injectible. I'm still on the 8 week schedule for Remicade. The MTX pills never worked as well for me as the injectible, so maybe part of my problem is the switch back. I'm going to ask about increasing one or the other drug when I call my RD--I'd forgotten how much I hate feeling like I've been run over by a large truck. J > Me. My RD has added one series of Rituxan and now we wait. Said it will > take three to four months to see an improvement. But it allows me to [quoted text clipped - 20 lines] >> Thanks, >> J > Has anyone had Remicade stop working? I started on it > a few years back (for RA) and was doing extremely well, > but in the last few weeks all the old symptoms started > coming back Since we've started a Remicade thread, I need to ask a question or 2 after showing this statement from Medicare: 40 infliximab injection $4,000.00 1 special supplies 35.00 1 normal saline solution 20.00 1 chemotherapy iv one hr 220.00 2 each addition hr 1-8 hr 120.00 1 additional sequential infuse 65.00 Claim Total $4,460.00 Has anyone taking Remicade been told they are also receiving chemotherapy? Does the nurse follow the warnings below? chemotherapy: drug agents used to treat infections, cancers, and other diseases and conditions. CAUTION: chemotherapeutic agents are poisons and pose risks to those who handle them, primarily pharmacists and nurses. Usually, only oncology practioners specifically thrined in chemotherapy administration should perform this task. The most important factor is reducing exposure is the use of proper protection when preparing and administering these agents. After washing hands, the health care provider dons appropriate powder-free or latex-free hypoallergenic chemotherapy gloves, a disposable impermeable gown, and goggles or a mask with face and eye shield. Eating, drinking, smoking, chewing gum, applying cosmetics, and storing food are prohibited in areas where drugs are stored or administered. The drugs should be administered in a calm environment, and all waste and equipment must be discarded in designated waste containers. Health care providers must follow OSHA guidelines. ... Impotence...nature's way of saying "No hard feelings." That is how the infusion room is booking the time you spend there or at least I am guessing that is what it is. I thought when the nurses in my infusion clinic book a medication, they use a certain phrase which will indicate a certain amount of time your use of the chair will take. I had thought it was only for booking time but it sounds like it must also be the cost of the 'bed' and their time. The Rituxan was booked as cite-o-kin [not sure if that was right but what ever it is means the patient would be there for five hours. Does that help? Duckie >>Has anyone had Remicade stop working? I started on it >>a few years back (for RA) and was doing extremely well, [quoted text clipped - 39 lines] > > ... Impotence...nature's way of saying "No hard feelings." Signature_('> (_<_) _ _('< -quack (_<_) _ __('< *QUACK!* <_{__) _('< "|,,|_" (_<_) _('< "AFLAC!" (_<_) Maybe that was cite-o-toxin... > That is how the infusion room is booking the time you spend there or at > least I am guessing that is what it is. I thought when the nurses in my [quoted text clipped - 5 lines] > patient would be there for five hours. Does that help? > Duckie >> Has anyone had Remicade stop working? I started on it >> a few years back (for RA) and was doing extremely well, [quoted text clipped - 15 lines] > receiving chemotherapy? Does the nurse follow the > warnings below? My appointments are booked as "chemotherapy" but I've assumed it is because the infusions are done in an oncology center, where most of the patients *are* getting chemo and, probably because of habit, the receptionist books every appointment that way. And as long as Blue Cross accepts the billing code and pays its 90%, I'm OK with it! JA > My appointments are booked as "chemotherapy" > but I've assumed it is because the infusions are done > in an oncology center, where most of the patients > *are* getting chemo I receive mine at the rheumatologist's office...five chairs and the other four could be receiving four different trial drugs. None of the chemo precautions spelled out in the warnings are adhered to. I have a Remicade infusion booked for tomorrow (Monday) and I'm going to be asking some questions. ... What do lawyers use for contraceptives? Their personalities. >My appointments are booked as "chemotherapy" >but I've assumed it is because the infusions are done [quoted text clipped - 3 lines] >And as long as Blue Cross accepts the billing code >and pays its 90%, I'm OK with it! I saw this on the Rheumatology site and they pushed to have it coded chemotherapy because they get a higher reimbursement rate. It is not a chemo drug, but rituxan is. -- MZ Visit my website: http://www.mzuschlag.com >I saw this on the Rheumatology site and they pushed to have it coded >chemotherapy because they get a higher reimbursement rate. It is not >a chemo drug, but rituxan is. -- MZ This is from the ACR website: In 2005, rheumatologists will be allowed to bill for infusions of monoclonal antibodies and other biologic response modifying agents with the same codes as oncologists and other physicians that utilize these treatments. In addition, there are other drug administration codes which rheumatologists will be able to use in this group. CMS created temporary G codes for these in 2005 which can be found in the chart with the national fee for each. They mentioned earlier that they wanted to use these codes because the the reimbursement rate is higher. They said on the site administration of the Biologics should be consider hazardous and complex like Chemo therapy, but the real issue was reimbursement IMHO. They were quite happy when it was approved. -- MZ Visit my website: http://www.mzuschlag.com I had the same problem. Remicade worked for almost a year and then it slowly stopped. I would have to go back more frequently for infusions and then I had a bad reaction to it and it stopped working altogether. I switched meds immediately. Hope it all works out for you...Good luck > Has anyone had Remicade stop working? I started on it a few years > back (for RA) and was doing extremely well, but in the last few weeks all [quoted text clipped - 8 lines] > Thanks, > J I had good results with remicade, experienced the fade, had the dose increased and the frequency of infusions also increased to six weeks. I had to stop taking remicade though because I developed a problem which the Rd believes was refractory to the remicade. I developed a severe swelling, redness, and pain in the lower legs that happened at about week four after an infusion. The docs did not know what it was, and the Rd said it reminded him of mediterranean fever. Since stopping remicade, I have not had this problem. My Rheumy said that it is now well known that the effect of remicade fades in time, and that the dose needs to be adjusted. I think the first thing to try would be changing the freqency from 8 weeks to 6, then try increasing the dose if that does not help. JMO Rose @}>->-- Being educated means that rather than fearing the unknown, one seeks to understand it. RB Please remove "Ima" to reply. I too had good results with remicade but had to move the treatments to every 6 weeks. I never have felt relief from the constant over-whelming fatique on remicade. I went into a flare when my husband passed away and prednisone seems to be the only thing that helps with pain. Prednisone gives me a boost and I dread the days ahead when I am totally weened off of it. Sus >I had good results with remicade, experienced the fade, had the dose > increased and the frequency of infusions also increased to six weeks. [quoted text clipped - 16 lines] > > Please remove "Ima" to reply. >I too had good results with remicade but had to move the treatments to >every 6 weeks. I never have felt relief from the constant over-whelming [quoted text clipped - 4 lines] > > Sus Hi Sus,,, being totally weaned off of prednisone does not keep me from having a prescription on the shelf if I need it. I do not fall back on it very often,,, its a mental thing. Harv |
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