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New Diagnosis of Polymyalgia Rheumatica (Husband)

Polymyalgia Rheumatica (PMR) | Last Active: Feb 29 2:49pm | Replies (102)
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@prestol

Actually, I am a big fan of biologic drugs! I have been taking one (inflixamab, brand name Inflectra) for many years to manage Crohn’s disease, with total remission for past 12 years and no side effects. I have been told I cannot take an IL6 inhibitor in addition. I am quite resistant to going off the inflixamab, and will be speaking with my gastroenterologist soon about alternatives. I don’t think there is anything as effective. As for the PMR, I need an alternative to prednisone because I have osteopenia (before treatment, full-blown osteoporosis), and my rheumatologist says MTX is the best option. No decision yet, and I remain on pred 30 for at least another week before attempting to taper.

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Replies to "Actually, I am a big fan of biologic drugs! I have been taking one (inflixamab, brand..."
DadCue | @dadcue | Feb 28 8:04pm

I was told the same about taking more than one biologic --- no can do!

Inflixamab, brand name Inflectra is a "biosimiliar" to Remicade---so a TNF-inhibitor. As you probably know, TNF-inhibitors haven't been shown to be efficacious for PMR/GCA.
https://pubmed.ncbi.nlm.nih.gov/17470831/
"Although too small to be definitive, the trial provides evidence that adding infliximab to prednisone for treating newly diagnosed polymyalgia rheumatica is of no benefit and may be harmful."

My ophthalmologist insisted on stopping Actemra (IL-6 inhibitor) because it wasn't an optimal treatment for uveitis. I was reluctant to stop Actemra because it worked so well for PMR. My rheumatologist said I should try Humira (TNF-inhibitor) to see if it works.

After two months I could tell Humira wasn't working well for PMR. Humira probably worked for uveitis. My rheumatologist said I needed to "give Humira a chance to see if it would work for PMR. He said I needed to be on Humira for at least 3 months to know if Humira would work or not." I gave Humira a chance to work and it still wasn't working.

I'm not advocating for any biologic. However, I think it is impossible to know what will work unless you try it to see. My rheumatologist said it would be impossible to optimally treat two different autoimmune disorders. He allowed me to pick the biologic that worked best for me.

I wish you luck with whatever is tried.

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