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PMR: Are there treatment alternatives to Prednisone?
Polymyalgia Rheumatica (PMR) | Last Active: Jan 11 7:08am | Replies (175)Comment receiving replies
My rheumatologist says he considers Actemra and Kavzara very similar and expects very similar results if they are used for treatment. Both disrupt the IL-6 immune pathway.
I am using Acterma to taper off Prednisone, and so far have tapered from 60 mg/day to 20 mg/day without relapse over a period of about 5 weeks.
Actemra is not officially FDA approved for PMR, but has been approved for GCA. Kevzara had been approved for PMR.
By the way, both of the corporate makers of these drugs have subsidy programs that can make them virtually free if you have commercial medical insurance.
Replies to "My rheumatologist says he considers Actemra and Kavzara very similar and expects very similar results if..."
I think your rheumatologist is on target. I’ll-6 is key
player in PMR and cytokine storm.
I paid to have mine drawn as a non-coverage expense at a reference lab and it was elevated while recovering.
Now I am a believer in the anti-inflammatory diet pattern.
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I'm not one to nitpick but I don't think the mechanism of action of Actemra and Kevzara disrupts the IL-6 immune pathway. That inflammation pathway is already out of control. The IL-6 inflammation pathway is vital for the immune system to function appropriately. Inflammation is "protective" as long as it is regulated by the body.
I love to generate discussions because I greatly appreciate the opinions of other people. I have posted the "bathtub theory" before about how Actemra works. I think Actemra "resets" IL-6 levels. This in turn down regulates runaway inflammation thereby allowing systemic inflammation to return to normal.
Remission is the state when inflammation isn't running wild and is regulated.
https://www.researchgate.net/figure/Mechanism-of-action-of-tocilizumab-in-RA-bathtub-theory_fig2_221967570I don't think anyone knows exactly how these biologics work. Immune treatments are very new but have shown great potential in the treatment of many diseases.
I'm just grateful that Actemra helps me and others. However, it might not work for everyone. My only regret so far is why I couldn't have tried Actemra sooner. I can't dwell on my past and I can't change that. I just wonder if some things could have been avoided.
It is possible for Actemra to stop working but that seems to be the case with all biologics. Who would have thought that the body can form anti-drug antibodies? When this happens, a biologic might not work as well or stop working altogether. That would be another topic for discussion.
The immune system is very complex.