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Benlysta Preauthorization Denied; Pain Meds That Help Lupus?

Posted by sarahintexas @sarahintexas, Mar 29 5:46pm

Hi all! Hope you're doing good. I learned last week that my insurance denied my doctor's preauthorization request for Benlysta, a biologic designed for Lupus. Disappointing to say the least.

Insurance is requiring I first try Plaquenil, which I understand is very common and foundational for many autoimmune conditions, but my doctor originally said it isn't "strong enough" for my numbers and pain symptoms, and so, that's why we started with Methotrexate (but had to stop because my white blood cells dropped too low).

Sigh. It's a process. But my pain while I wait 2-4 months for Plaquenil to kick in isnt adequately resolved by daily Prednisone, and I'm having to temporarily add pain meds.

Questions: Has anyone tried Benlysta for Lupus? Did it resolve joint and/or muscle pain? How long did it take to kick in?

And, has anyone found a prescription pain med that helps with autoimmune joint and muscle pain, as a bridge while finding the right immuno modulator/immuno suppressant? I'm hearing good things about Cymbalta.

Thank you!

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lmpa65 | @lmpa65 | Apr 23 2:44pm
In reply to @sarahintexas "Hi Judy! Thanks so much for reaching out and sharing. I'm so sorry for what your..." + (show)
Profile picture for sarahintexas @sarahintexas

Hi Judy! Thanks so much for reaching out and sharing. I'm so sorry for what your daughter is enduring. I hope she is able to find relief and care from her doctor(s). I saw my Rheumatologist today, and am 9 days in to my Plaquenil prescription, while still on 20mg daily Prednisone. We will be giving Plaquenil one month to resolve my joint and myofascial pain; if it does not, we will resubmit the request for Benlysta preauthorization to my insurance. (My doctor did appeal/argue my first denial, and provided details for why Plaquenil is not considered the appropriate medicine based on my numbers, but to no avail. Seems to be a trend at the moment). I haven't yet tried my Cymbalta or Gaba prescriptions from my GP, but feel..safer having them available if days get worse while we test Plaquenil. I do understand from my GP that Cymbalta is an SNRI at first, which can also offer musculoskeletal pain relief; my GP has had success with several patients. But will definitely stay on the lookout for worsening mental health if I try Cymbalta - thank you for the warning. Best of luck to your daughter, and you as caregiver!

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@sarahintexas gabapentin and Cymbalta are both medications that should be taken daily as usually prescribed. When taking the it takes at the very least two weeks to see the benefits. Those two drugs do not help acutely for pain.
Laura

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lmpa65 | @lmpa65 | Apr 23 2:46pm
In reply to @lmpa65 "@sarahintexas gabapentin and Cymbalta are both medications that should be taken daily as usually prescribed. When..." + (show)
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@sarahintexas gabapentin and Cymbalta are both medications that should be taken daily as usually prescribed. When taking the it takes at the very least two weeks to see the benefits. Those two drugs do not help acutely for pain.
Laura

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@mech
I have been on Gabapentin for several years and it has helped with pain.

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mech | @mech | Apr 23 3:18pm

My rheumy put me on hydroxychloroquin

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sarahintexas | @sarahintexas | Apr 25 5:01pm
In reply to @lmpa65 "@sarahintexas gabapentin and Cymbalta are both medications that should be taken daily as usually prescribed. When..." + (show)
Profile picture for lmpa65 @lmpa65

@sarahintexas gabapentin and Cymbalta are both medications that should be taken daily as usually prescribed. When taking the it takes at the very least two weeks to see the benefits. Those two drugs do not help acutely for pain.
Laura

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@lmpa65 Thank you Laura! Thankfully I haven't yet needed to start my Gaba or Cymbalta prescriptions, as the Plaquenil has reduced my joint and fascia pain by about 50% over the last 3.5 weeks. Hoping for more relief as I go!

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sarahintexas | @sarahintexas | Apr 25 5:01pm
In reply to @lmpa65 "@mech I have been on Gabapentin for several years and it has helped with pain." + (show)
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@mech
I have been on Gabapentin for several years and it has helped with pain.

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@lmpa65 Glad to hear this for you!

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sarahintexas | @sarahintexas | Apr 25 5:03pm
In reply to @mech "My rheumy put me on hydroxychloroquin" + (show)
Profile picture for mech @mech

My rheumy put me on hydroxychloroquin

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@mech I hope it brings you some relief!

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pgn | @pgn | Apr 26 3:26pm

I’ve had Lupus and autoimmune hepatitis for about 14 years. I’ve always taken Azathioprine due to developing a severe rash to Plaquinel. I deal with low white and red counts. I was on a low dose of prednisone for about 7-8 years. And slowly came off that. Due to my hepatitis I’ve never been able to take pain meds. They are thinking about a low dose of Budesonide to help with the elevated liver enzymes.
It’s all such a balancing act.
Now it’s osteoporosis (have taken Synthroid for 50+ years) and having terrible side affects from the biophosphates.
So not being able to take pain meds has been hard.
My best to all who are dealing with these tough diseases and showing such resilience and strength.

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sarahintexas | @sarahintexas | May 4 10:25am
In reply to @pgn "I’ve had Lupus and autoimmune hepatitis for about 14 years. I’ve always taken Azathioprine due to..." + (show)
Profile picture for pgn @pgn

I’ve had Lupus and autoimmune hepatitis for about 14 years. I’ve always taken Azathioprine due to developing a severe rash to Plaquinel. I deal with low white and red counts. I was on a low dose of prednisone for about 7-8 years. And slowly came off that. Due to my hepatitis I’ve never been able to take pain meds. They are thinking about a low dose of Budesonide to help with the elevated liver enzymes.
It’s all such a balancing act.
Now it’s osteoporosis (have taken Synthroid for 50+ years) and having terrible side affects from the biophosphates.
So not being able to take pain meds has been hard.
My best to all who are dealing with these tough diseases and showing such resilience and strength.

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@pgn Hi, thank you for sharing - I'm sorry to hear about all you're experiencing. I stopped daily Prednisone about a week ago, which helped confirm that Plaquenil alone is not resolving my pain - its much worse without Prednisone. I did receive good news yesterday - after two appeals and proof that Plaquenil isn't sufficient, my insurance approved me for Benlysta. I'll begin mid-May and am hopeful for better results. Thanks again and wishing you comfort.

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