My rheumatology visit went well but now gout has been added to my list of inflammatory conditions.
As for stopping Actemra (tocilizumab) --- it doesn't seem like it will ever be stopped. Now that gout has been diagnosed ... Actemra might help gout too.
"Extensive research has elucidated the close association of IL-6 and its receptors or their mediated signaling pathways with gout and their contribution to its pathogenesis [9], [10]. The efficacy of treatment has been validated with the introduction of tocilizumab (TCZ), the first approved biologic agent targeting IL-6 and its receptors, demonstrating promising clinical responses in individual cases with refractory tophaceous gout and crystal arthritis [10], [11], [12], [13], [14]. Furthermore, inhibition of the IL-6 and its receptor-mediated signaling pathway has been shown to attenuate gouty immune inflammatory responses [15], suggesting that targeting IL-6 and its receptors or modulating their mediated signaling pathways may offer a novel approach and direction for gout therapy, indicating that blocking IL-6 signaling has the potential to treat these diseases."
https://www.sciencedirect.com/science/article/pii/S1043466624002084#:~:text=In%20most%20current%20studies%20on,in%20the%20adaptive%20immune%20system.
----------------------
The association of gout with PMR is also interesting.
"Contrary to our hypothesis, gout was independently associated with a 2.1- to 2.5-fold higher risk of PMR in elderly Americans who were recipients of Medicare. This does not imply a causal relationship, only that an existing diagnosis of gout was associated with a higher hazard (risk) of a new PMR diagnosis"
https://pmc.ncbi.nlm.nih.gov/articles/PMC6649982/
"We speculate that based on these studies, some disease mechanisms of PMR and a strongly associated condition (giant cell arteritis) have similarities to those in gout. Increased production of IL-1 and IL-6 in both conditions might represent one of the common pathways for gout and PMR that plays a role in pathogenesis of these conditions."
----------------------
To my knowledge ... my uric acid level was never checked until I had kidney stones that were composed mostly of uric acid.
Does anyone else have PMR and gout?
If it isn't one thing it is another thing. In my case, my rheumatologist says it is a full spectrum of things!
Four different rheumatologists came into my room when it was determined that I had gout ... they all wanted to see the evidence.
Hello @dadcue an FYI for you re this company ( GROBio) that shared space with my company at Harvard Life Lab. this might be to soon to ask , but have your Drs mentioned uricases ?
https://grobio.com/our-programs/#progly-indications
"The first indication we are pursuing to eliminate therapeutic immunogenicity is gout, a type of arthritis that causes debilitating inflammation of joints due to excess uric acid buildup. Symptoms include intense pain, discoloration or redness, stiffness, swelling, and extreme tenderness. Therapeutic treatment for severe, refractory gout can include uricase enzyme to break up uric acid crystal deposits and reduce serum uric acid levels. However, the majority of patients receiving uricase treatment, such as Krystexxa® (pegloticase), develop anti-drug antibodies (ADAs) that clear the enzyme from circulation, compromising treatment safety and efficacy and leaving patients without treatment options. GRObio is using our ProGly NSAAs to develop ProGly-Uricase that prevents anti-uricase ADAs to provide a novel, safe and effective uricase for patients with severe, refractory gout."