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Best Treatment

Posted: Fri Oct 11, 2013 2:00 pm
by refinnej30
Hello Mike.

Just found out that I might have Ankylosing Spondylitis along with Uveitis, I am HLA B27+. Dr. Foster advised me to take Cellcept for the Uveitis, but wasn't sure what the recommended treatment is for AS? My Rheumy just told me that Cellcept wasn't the best for AS, but she is trying that first to see how I do. She just saw the inflammation on my spinal x-rays and said it looks like AS, but wanted to study it more before moving forward with the treatment for the AS. I wanted to make sure that I address both issues and I remember you said not to use Enbrel. It's great to understand why I feel so awful all the time and am excited (a little nervous too) to try a new treatment to give me my life back. Any info would be appreciated.

Thank you,
Jennifer

Re: Best Treatment

Posted: Fri Oct 11, 2013 2:39 pm
by Mike Bartolatz
if NSAID therapy doesn't help you, then usually the doctors and insurance companies want to first try DMARD drugs such as Methotrexate, Cellcept or Imuran for the Ankylosing spondylitis and these meds also work very well for uveitis. sometimes they will add a TNF A blocking medication to the DMARD drugs. Plaquenil has no use in Uveitis. it can even cause retina problems. the TNF A blocking drugs REMICADE (best results for uveitis) and Humira (not as good as Remicade it seems) are added to one of the DMARD drugs to get the best results for uveitis and AS if I recall correctly.

MTX often has side effects of extreme nausea so if it is given, get an anti nausea med such as Zofran to take along with it.

also take Folic acid to help prevent other side effects such as hair loss taken the day after taking the MTX. if nausea becomes a problem often the once a week dose is divided into two doses once in the morning and once at night, at higher levels it is given by injection like a diabetic gives insulin into fatty tissue of the abdomen, arm or thigh.

hope this helps,
Mike
PS: DR Foster is the BEST. tell him Hi for me please msb