Iritis and Psoriatic Arthritis - UGH!

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Jenjl
Posts: 1
Joined: Tue Jan 29, 2013 12:27 pm

Iritis and Psoriatic Arthritis - UGH!

Post by Jenjl »

Hi Everyone,
Thanks for posting all of this great info. I got my first bout of Iritis in Oct. of 2006. Like some other folks, because it was the first time my eye doc wasn't too concerned. He treated it w/ Prednisolone and hematropine (sp?) and I didn't really really think much about it. After 3 additional bouts I started googling "recurring iritis". I read there was a link between iritis and connective tissue disorders and BINGO! the light went on! I'd been having "issues" with my hamstring & hips since 2006 as well. Rest, heat, ice, physical therapy, cortisone shots and prolotherapy did not help. So I took my Iritis history to my PCP and she issued some blood work. Turns out I am HLA-B27 positive and I learned there was history in my family. The first rheumy I saw agreed that something was wrong, but didn't give me an official diagnosis (despite the pain I had and oh that's right - the psoriasis on my scalp - how did he miss that connection?!). NSAIDs didn't work and I didn't want to try anything else as my husband and I were trying for #2. After #2 the pain came back as well as major depression. My new rheumy suspected it was Psoriatic Arthritis, but wanted to run a bunch of bloodwork to rule other stuff like Lymes & RA out. In the middle of her analysis I had another bout of Iritis, but since I was already on prednisone this flareup was not as painful. So now I officially have PsA and had my first injection of Simponi 2 weeks ago. I know the TNF blockers take a while before you can see a difference, but boy am I in pain (not in the eye, but everywhere else). I'm hoping the Simponi will help the Iritis from coming back too... any thoughts on that? Thanks!
Last edited by Jenjl on Tue Mar 19, 2013 12:00 pm, edited 1 time in total.
Mike Bartolatz
Posts: 6595
Joined: Fri Feb 06, 2004 9:58 pm

Re: Iritis and Psoriatic Arthritis - UGH!

Post by Mike Bartolatz »

with uveitis, Remicade and Humira are the TNF A blocking drugs to use, and Remicade seems to work the best.
there is also another drug called Stelara for moderate to severe Plaque Psoriasis that you might try if you fail the TNF A blocking drugs. it works differently by blocking the IL23R gene the triggers the IL17 class of cytokines that do damage from Psoriasis and iritis when linked together.
usually HLA B27 related uveitis and psoriasis are treated with the DMARD drugs. Methotrexate being the first tried when NSAIDs don't work to control it or to put it into remission. usually MTX and a TNF A blocking drug are used together for best results.

I strongly urge you to get an expert in treating uveitis on your team, an ocular Immunologist if at all possible because rheumatologist rarely have the experience to adequetly treat uveitis patients. often Methotrexate has to be at a higher level than the rheumatologist is used to using. the Remicade infusions also have to be at a shorter interval of 6weeks or even monthly. a list of ocular immunologists is in the PATIENT information section of http://www.uveitis.org or tell me where you live and I will suggest the closest specialist to you for a consultation.

wish you the best,
Mike
Mike Bartolatz
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