Kevzara and prednisone effectivness

@stonewheel

Did you get Cosentyx approved for PsA or PMR?

Doctors can prescribe anything they want. Getting insurance to pay for it is another matter. Most insurance won't pay for an expensive medication unless it is FDA approved for the condition being treated. Cosentyx isn't FDA approved for PMR yet. Cosentyx is FDA approved for PsA

Prednisone isn't FDA approved for PMR either. Prednisone became the standard of care before the FDA requirements were involved. Insurance will gladly pay for prednisone because the medication itself is cheap. I think Prednisone is more costly to the health care system in general when you add in the cost to treat all the side effects. Managing complications—such as osteoporosis and fractures, secondary diabetes, high blood pressure, cataracts, and infections—add additional costs. If my PE was caused by Prednisone like it was believed then my ICU admission wasn't cheap. All of the emergency room visits I had over the years while I took Prednisone were costly too.

I haven't had any complications like those I mentioned since starting Actemra. I was able to discontinue all of my medications for BP, cholesterol, etc which I needed when I was taking Prednisone.

@dadcue makes me wonder, even though cosentyx seems to be in my formulary, can my rheumatologist just call that perscription into the specialty pharmacy, or does she have to prove it. Like by saying kevzara is only working 80%. And if the cosentyx doesn't work is it easy to switch back ?

@stonewheel

Did you get Cosentyx approved for PsA or PMR?

Doctors can prescribe anything they want. Getting insurance to pay for it is another matter. Most insurance won't pay for an expensive medication unless it is FDA approved for the condition being treated. Cosentyx isn't FDA approved for PMR yet. Cosentyx is FDA approved for PsA

Prednisone isn't FDA approved for PMR either. Prednisone became the standard of care before the FDA requirements were involved. Insurance will gladly pay for prednisone because the medication itself is cheap. I think Prednisone is more costly to the health care system in general when you add in the cost to treat all the side effects. Managing complications—such as osteoporosis and fractures, secondary diabetes, high blood pressure, cataracts, and infections—add additional costs. If my PE was caused by Prednisone like it was believed then my ICU admission wasn't cheap. All of the emergency room visits I had over the years while I took Prednisone were costly too.

I haven't had any complications like those I mentioned since starting Actemra. I was able to discontinue all of my medications for BP, cholesterol, etc which I needed when I was taking Prednisone.

@dadcue
Both, as it logically is a better fit for me.

Probably included words like sausage fingers (which I said so her AI could note it) and included that they weee paying for CBC labs every week but my WBC, anc and platelet counts were too low to take Kevzara and have been for over 4 weeks.

Restarting Prednisone (I’ve successfully tapered off with the help of an IL targeting biologic) could hospitalize me, as it did in the beginning ($50k/ day) + meds) which met my Advantage Plan part D deductible on January 6, of this year.

You may remember, I went to the ER on Jan. 3 and was released on the 7th, but should have gone in on Jan 1.
(Happy New Year!) The ER was full of flu patients and I didn’t want to go be around that. Eventually, I figured that if I got the flu there, that I was at the right place to be with the flu. So I went.

…Fast forward 9 months:
I’m sure that with sound medical reason, logic and proper punctuation (very important) she told them the truth.

I learned early in life that it is the whole truth that sets you free, a partial truth will do damage.

Did my first Kevzara injection today in the clinic. iIm SO hopeful and excited! I mean i know it may not help me but it may! I am six months in to PMR and still on 12.5mg prednisone as i've not been able to taper without flaring. But I have so many prednisone side effects. I so look forward to successful tapering!

@stonewheel

You had a large DVT as I recall. You were lucky it didn't move to your lungs.
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It was a convoluted process when I was approved for Actemra. My rheumatolgist first wanted my "commitment " to try Actemra "ONLY IF" he could get Actemra approved for me. I agreed without knowing anything. I asked another doctor if Actemra would be approved for PMR. That doctor told me it was "unlikely" so I didn't think my commitment mattered.

I was on another PMR forum at the time and asked if anyone had experience with Actemra for PMR. I received negative feedback because "prednisone was the only option" and "black box warnings" --- basically nothing positive. Nobody had ever tried Actemra for PMR so I was surprised by all of the negative opinions. When Actemra was approved, I almost refused it except for the commitment I made. I didn't have to try Actemra and almost backed out of my commitment. That was when my rheumatologist said "I wouldn't know if Actemra worked or not unless I tried it."

I was very pessimistic about Actemra. I expected that it wouldn't work. At one stage when I tapered prednisone by 1 mg per week because I wanted to get the "inevitable flare" over with.

I read the request for approval that was submitted. My rheumatologist was completely honest. The justification wasn't for PMR so much. It was mostly about being on prednisone for decades. "All other options had been tried and failed" to get me off prednisone. My rheumatolgist stated that Actemra was my "best chance" of ever getting off prednisone.

At the time, Actemra was recently FDA approved for GCA. My rheumatologist never claimed that I had GCA or RA or anything else that Actemra was FDA approved for. There was some kind of panel that reviewed my medical records. They decided to approve Actemra with one stipulation. I had to be treated with the protocol "AS IF" I had GCA.