Re: Multiple Monoclonal Antibodies at Once?

[Guest guest]

I would think about investigating the cost and coverage of having one

of your docs consult with someone at National Jewish or Mayo or

somewhere. Most of those big time hospitals offer that type of

service (I know NJ does). They are most likely the ones to have had

multiple patients on several types of treatments and to have

information. The other is to have each doctor contact the drug rep

and ask for other docs they could contact.... I would also call the

specialty pharmacy that dishes out your Xolair and ask to speak to one

of the pharmacists.

We have had some discussions in the past on this board about asthma

and arthritis. The last time, a number of us posted that we have

parents and grandparents with arthritis and signs of getting it

ourselves. MY theory is that some of us have immune systems that are

inflammation-prone, and that there is a link between the inflammatory

diseases based on immunity, but not a direct cause/effect link,(i.e.,

asthma doesn't cause arthritis and vice/versa). A genetic variant in

our immune system could certainly explain this AND explain why not

everyone with asthma gets arthritis and vice/versa.

My three cents,

Addy

Group co-owner

>

> I saw a rheumatologist about a week ago who thinks I might have

psoriatic arthritis. Whatever - I'm sure hurting all over again. She

ordered around a dozen blood tests and several x-rays. Next week I'll

get the results. I will have to say that she was much more thorough

than most other docs have been, and especially rheumatologists.

>

> During our conversation I mentioned being on Xolair. She

responded wryly with " how much does it cost? " and " we can control

that for $15 a month " (i.e., meaning using a completely different drug

like a steroid !!!) I was a little annoyed at the slightly cavalier

attitude and explained that I had had years of allergic asthma and

infections that had actually damaged my lungs. That subject was

dropped, however, she mentioned treating the arthritis with a

monoclonal antibody and that I could not be on both at once.

>

> I was wondering what is known about this? Xolair goes for the IgE

and is very different as I understand it than the drugs like Enbrel

(just for example) that must target a different immunoglobulin. So,

would it be possible to be on 2 different monoclonal antibodies at the

same time? Has anyone looked into this?

>

> I've heard that it's not uncommon for someone with asthma and

allergies to have arthritis. One dermatologist (who was quite snitty)

informed me that they see this a lot - unfortunately he didn't have

any cures or good suggestions, either.

>

> Thx!!!

>

>

> ---------------------------------

> Building a website is a piece of cake.

> Small Business gives you all the tools to get online.

>

>

[Guest guest]

I met a respirologist who told me outright that xolair was " expensive crap " . As

treatments go, it is expensive and not everyone has remotely close to any of the

more " miraculous " results described by our members.

Enbrel is a monoclonal antibody to tumor necrosis factor alpha. It is completely

unrelated to IgE. As costly as xolair if not more. I would have your new rheumy

consult the patient assistance program to see if they are compatible. To my

knowledge, there are no studies with ppl with such dual diagnoses on both meds.

C

----- Original Message ----

From: SD Designer <instdesgn1@...>

Sent: Wednesday, September 26, 2007 4:02:59 PM

Subject: [ ] Multiple Monoclonal Antibodies at Once?

I saw a rheumatologist about a week ago who thinks I might have psoriatic

arthritis. Whatever - I'm sure hurting all over again. She ordered around a

dozen blood tests and several x-rays. Next week I'll get the results. I will

have to say that she was much more thorough than most other docs have been, and

especially rheumatologists.

During our conversation I mentioned being on Xolair. She responded wryly with

" how much does it cost? " and " we can control that for $15 a month " (i.e.,

meaning using a completely different drug like a steroid !!!) I was a little

annoyed at the slightly cavalier attitude and explained that I had had years of

allergic asthma and infections that had actually damaged my lungs. That subject

was dropped, however, she mentioned treating the arthritis with a monoclonal

antibody and that I could not be on both at once.

I was wondering what is known about this? Xolair goes for the IgE and is very

different as I understand it than the drugs like Enbrel (just for example) that

must target a different immunoglobulin. So, would it be possible to be on 2

different monoclonal antibodies at the same time? Has anyone looked into this?

I've heard that it's not uncommon for someone with asthma and allergies to have

arthritis. One dermatologist (who was quite snitty) informed me that they see

this a lot - unfortunately he didn't have any cures or good suggestions, either.

Thx!!!

------------ --------- --------- ---

Building a website is a piece of cake.

Small Business gives you all the tools to get online.

[Guest guest]

That's strange. I met a woman today when I went for my xolair shot and she said

she had taken xolair for a year and a half and had stopped because she was so

much better--Wonder who this respiro. person has talked to. I hope my doctor

doesn't suggest I stop taking it!

<carrie72583@...> wrote: I met a respirologist who told me

outright that xolair was " expensive crap " . As treatments go, it is expensive and

not everyone has remotely close to any of the more " miraculous " results

described by our members.

Enbrel is a monoclonal antibody to tumor necrosis factor alpha. It is completely

unrelated to IgE. As costly as xolair if not more. I would have your new rheumy

consult the patient assistance program to see if they are compatible. To my

knowledge, there are no studies with ppl with such dual diagnoses on both meds.

C

----- Original Message ----

From: SD Designer <instdesgn1@...>

Sent: Wednesday, September 26, 2007 4:02:59 PM

Subject: [ ] Multiple Monoclonal Antibodies at Once?

I saw a rheumatologist about a week ago who thinks I might have psoriatic

arthritis. Whatever - I'm sure hurting all over again. She ordered around a

dozen blood tests and several x-rays. Next week I'll get the results. I will

have to say that she was much more thorough than most other docs have been, and

especially rheumatologists.

During our conversation I mentioned being on Xolair. She responded wryly with

" how much does it cost? " and " we can control that for $15 a month " (i.e.,

meaning using a completely different drug like a steroid !!!) I was a little

annoyed at the slightly cavalier attitude and explained that I had had years of

allergic asthma and infections that had actually damaged my lungs. That subject

was dropped, however, she mentioned treating the arthritis with a monoclonal

antibody and that I could not be on both at once.

I was wondering what is known about this? Xolair goes for the IgE and is very

different as I understand it than the drugs like Enbrel (just for example) that

must target a different immunoglobulin. So, would it be possible to be on 2

different monoclonal antibodies at the same time? Has anyone looked into this?

I've heard that it's not uncommon for someone with asthma and allergies to have

arthritis. One dermatologist (who was quite snitty) informed me that they see

this a lot - unfortunately he didn't have any cures or good suggestions, either.

Thx!!!

------------ --------- --------- ---

Building a website is a piece of cake.

Small Business gives you all the tools to get online.

[Guest guest]

>

> That's strange. I met a woman today when I went for my xolair shot

and she said she had taken xolair for a year and a half and had

stopped because she was so much better--Wonder who this respiro.

person has talked to. I hope my doctor doesn't suggest I stop taking

it!

>

When had become so much improved, I also asked my doctor if I could go

off Xolair. He said " Why do you think your asthma is so much improved?

Good grief NO! "

Doug

Group founder

[Guest guest]

Yeah, I wanted to ask her why her doctor had let her go off of it! The irony is

that she had been sick for three days, was in to see the doctor and asked for a

note so she could go back to work--obviously allergy related, since this was at

the allergy clinic! I wanted to ask her, but it just wasn't the place nor the

time. I sure couldn't understand it. Not having any kind of respiratory

infection, nor feeling like I can't breathe because of the infection has been so

great that I think I would argue with my doc if he suggested I might not need it

anymore!

I guess she had her reason......

uca79iii <bme1979@...> wrote:

--- In , Adah Voigt <asthmatic50@...>

wrote:

>

> That's strange. I met a woman today when I went for my xolair shot

and she said she had taken xolair for a year and a half and had

stopped because she was so much better--Wonder who this respiro.

person has talked to. I hope my doctor doesn't suggest I stop taking

it!

>

When had become so much improved, I also asked my doctor if I could go

off Xolair. He said " Why do you think your asthma is so much improved?

Good grief NO! "

Doug

Group founder

---------------------------------

oneSearch: Finally, mobile search that gives answers, not web links.

[Guest guest]

Hmmmmm interesting. I have Psoriatic arthritis and have had to step up my meds

for it this week. One of the options I was given was Enbrel ...... no mention

of it possibly not being compatible with the Xolair. We ended up going the

Metholtrexate injections route due to the fact I have had decent results from it

before and I also have had discussions with my asthma dr that it could be

beneficial there as well so we are trying that first. In any case I go back to

my rheumatologist in 2 weeks so I will ask that specifically again.

----- Original Message ----

From: <carrie72583@...>

Sent: Wednesday, September 26, 2007 11:16:31 PM

Subject: Re: [ ] Multiple Monoclonal Antibodies at Once?

I met a respirologist who told me outright that xolair was " expensive crap " . As

treatments go, it is expensive and not everyone has remotely close to any of the

more " miraculous " results described by our members.

Enbrel is a monoclonal antibody to tumor necrosis factor alpha. It is completely

unrelated to IgE. As costly as xolair if not more. I would have your new rheumy

consult the patient assistance program to see if they are compatible. To my

knowledge, there are no studies with ppl with such dual diagnoses on both meds.

C

----- Original Message ----

From: SD Designer <instdesgn1 (DOT) com>

Sent: Wednesday, September 26, 2007 4:02:59 PM

Subject: [ ] Multiple Monoclonal Antibodies at Once?

I saw a rheumatologist about a week ago who thinks I might have psoriatic

arthritis. Whatever - I'm sure hurting all over again. She ordered around a

dozen blood tests and several x-rays. Next week I'll get the results. I will

have to say that she was much more thorough than most other docs have been, and

especially rheumatologists.

During our conversation I mentioned being on Xolair. She responded wryly with

" how much does it cost? " and " we can control that for $15 a month " (i.e.,

meaning using a completely different drug like a steroid !!!) I was a little

annoyed at the slightly cavalier attitude and explained that I had had years of

allergic asthma and infections that had actually damaged my lungs. That subject

was dropped, however, she mentioned treating the arthritis with a monoclonal

antibody and that I could not be on both at once.

I was wondering what is known about this? Xolair goes for the IgE and is very

different as I understand it than the drugs like Enbrel (just for example) that

must target a different immunoglobulin. So, would it be possible to be on 2

different monoclonal antibodies at the same time? Has anyone looked into this?

I've heard that it's not uncommon for someone with asthma and allergies to have

arthritis. One dermatologist (who was quite snitty) informed me that they see

this a lot - unfortunately he didn't have any cures or good suggestions, either.

Thx!!!

------------ --------- --------- ---

Building a website is a piece of cake.

Small Business gives you all the tools to get online.

[Guest guest]

I am so glad you responded. Please, please, tell me if you are on

BOTH xolair AND methyltrexate or enbrel at the SAME TIME.

I see rheumy tomorrow morning (Mon.) and would like to give her some

sage advice (?!?!) re what I can take based on others' experience.

Someone mentioned having her call Mayo or National Jewish or talk to

other docs w/patients in similar circumstances. I'm thinking about

that now ......

One of the side effects I've read about the psoratic arthritis drugs

(like enbrel) is that they can cause lung infections. That has me

WORRIED! One of the reasons I went on xolair is due to the long term

lung infections I was having and the damage they did to my lungs.

Soooo, I'm not sure how to push on this.

Please stay tuned, if you don't mind. I'll try to report back what's

happening.

>

> Hmmmmm interesting. I have Psoriatic arthritis and have had to

step up my meds for it this week. One of the options I was given was

Enbrel ...... no mention of it possibly not being compatible with the

Xolair. We ended up going the Metholtrexate injections route due to

the fact I have had decent results from it before and I also have had

discussions with my asthma dr that it could be beneficial there as

well so we are trying that first. In any case I go back to my

rheumatologist in 2 weeks so I will ask that specifically again.

>

>

> ----- Original Message ----

> From: <carrie72583@...>

>

> Sent: Wednesday, September 26, 2007 11:16:31 PM

> Subject: Re: [ ] Multiple Monoclonal Antibodies at Once?

>

> I met a respirologist who told me outright that xolair

was " expensive crap " . As treatments go, it is expensive and not

everyone has remotely close to any of the more " miraculous " results

described by our members.

>

> Enbrel is a monoclonal antibody to tumor necrosis factor alpha. It

is completely unrelated to IgE. As costly as xolair if not more. I

would have your new rheumy consult the patient assistance program to

see if they are compatible. To my knowledge, there are no studies

with ppl with such dual diagnoses on both meds.

>

> C

>

> ----- Original Message ----

> From: SD Designer <instdesgn1 (DOT) com>

>

> Sent: Wednesday, September 26, 2007 4:02:59 PM

> Subject: [ ] Multiple Monoclonal Antibodies at Once?

>

> I saw a rheumatologist about a week ago who thinks I might have

psoriatic arthritis. Whatever - I'm sure hurting all over again. She

ordered around a dozen blood tests and several x-rays. Next week I'll

get the results. I will have to say that she was much more thorough

than most other docs have been, and especially rheumatologists.

>

> During our conversation I mentioned being on Xolair. She responded

wryly with " how much does it cost? " and " we can control that for $15

a month " (i.e., meaning using a completely different drug like a

steroid !!!) I was a little annoyed at the slightly cavalier attitude

and explained that I had had years of allergic asthma and infections

that had actually damaged my lungs. That subject was dropped,

however, she mentioned treating the arthritis with a monoclonal

antibody and that I could not be on both at once.

>

> I was wondering what is known about this? Xolair goes for the IgE

and is very different as I understand it than the drugs like Enbrel

(just for example) that must target a different immunoglobulin. So,

would it be possible to be on 2 different monoclonal antibodies at

the same time? Has anyone looked into this?

>

> I've heard that it's not uncommon for someone with asthma and

allergies to have arthritis. One dermatologist (who was quite snitty)

informed me that they see this a lot - unfortunately he didn't have

any cures or good suggestions, either.

>

> Thx!!!

>

> ------------ --------- --------- ---

> Building a website is a piece of cake.

> Small Business gives you all the tools to get online.

>

>

[Guest guest]

One other thought and I know how off-the-wall this sounds in

mainstream healthcare, but, do you by any chance notice a worsening

of arthritis when allergies get worse? i.e., like a bumper crop of

ragweed here plus a recent cold/infection that I had and took

antibiotics for. Am recovered from cold but slightly more asthmatic

symptoms and more achiness etc. that goes w/psoriatic arthritis.

>

> Hmmmmm interesting. I have Psoriatic arthritis and have had to

step up my meds for it this week. One of the options I was given was

Enbrel ...... no mention of it possibly not being compatible with the

Xolair. We ended up going the Metholtrexate injections route due to

the fact I have had decent results from it before and I also have had

discussions with my asthma dr that it could be beneficial there as

well so we are trying that first. In any case I go back to my

rheumatologist in 2 weeks so I will ask that specifically again.

>

>

> ----- Original Message ----

> From: <carrie72583@...>

>

> Sent: Wednesday, September 26, 2007 11:16:31 PM

> Subject: Re: [ ] Multiple Monoclonal Antibodies at Once?

>

> I met a respirologist who told me outright that xolair

was " expensive crap " . As treatments go, it is expensive and not

everyone has remotely close to any of the more " miraculous " results

described by our members.

>

> Enbrel is a monoclonal antibody to tumor necrosis factor alpha. It

is completely unrelated to IgE. As costly as xolair if not more. I

would have your new rheumy consult the patient assistance program to

see if they are compatible. To my knowledge, there are no studies

with ppl with such dual diagnoses on both meds.

>

> C

>

> ----- Original Message ----

> From: SD Designer <instdesgn1 (DOT) com>

>

> Sent: Wednesday, September 26, 2007 4:02:59 PM

> Subject: [ ] Multiple Monoclonal Antibodies at Once?

>

> I saw a rheumatologist about a week ago who thinks I might have

psoriatic arthritis. Whatever - I'm sure hurting all over again. She

ordered around a dozen blood tests and several x-rays. Next week I'll

get the results. I will have to say that she was much more thorough

than most other docs have been, and especially rheumatologists.

>

> During our conversation I mentioned being on Xolair. She responded

wryly with " how much does it cost? " and " we can control that for $15

a month " (i.e., meaning using a completely different drug like a

steroid !!!) I was a little annoyed at the slightly cavalier attitude

and explained that I had had years of allergic asthma and infections

that had actually damaged my lungs. That subject was dropped,

however, she mentioned treating the arthritis with a monoclonal

antibody and that I could not be on both at once.

>

> I was wondering what is known about this? Xolair goes for the IgE

and is very different as I understand it than the drugs like Enbrel

(just for example) that must target a different immunoglobulin. So,

would it be possible to be on 2 different monoclonal antibodies at

the same time? Has anyone looked into this?

>

> I've heard that it's not uncommon for someone with asthma and

allergies to have arthritis. One dermatologist (who was quite snitty)

informed me that they see this a lot - unfortunately he didn't have

any cures or good suggestions, either.

>

> Thx!!!

>

> ------------ --------- --------- ---

> Building a website is a piece of cake.

> Small Business gives you all the tools to get online.

>

>

[Guest guest]

Yes, I am on the Xolair (started in May) and the methotrexate which I started

this week. Most of the advanced treatments for arthritis have some effect on

the immune system which is what increases the chances of lung infections and

such. When I was on the methotrexate before I didn't have any major issues of

that sort but I also did not have asthma then. I will definitely be much more

dilligent when I think a cold has been around too long or is not a normal cold!!

I had been on so much prednisone the arthritis had been better for a while but

since starting the Xolair we have decreased the prednisone some and the

arthritis is getting bad again. I go to the infusion center tomorrow for my

Xolair and I will also ask if they have any patients who get both. I'll let you

know what I find out.

----- Original Message ----

From: instdesgn1 <instdesgn1@...>

Sent: Sunday, September 30, 2007 8:11:21 PM

Subject: [ ] Re: Multiple Monoclonal Antibodies at Once?

I am so glad you responded. Please, please, tell me if you are on

BOTH xolair AND methyltrexate or enbrel at the SAME TIME.

I see rheumy tomorrow morning (Mon.) and would like to give her some

sage advice (?!?!) re what I can take based on others' experience.

Someone mentioned having her call Mayo or National Jewish or talk to

other docs w/patients in similar circumstances. I'm thinking about

that now ......

One of the side effects I've read about the psoratic arthritis drugs

(like enbrel) is that they can cause lung infections. That has me

WORRIED! One of the reasons I went on xolair is due to the long term

lung infections I was having and the damage they did to my lungs.

Soooo, I'm not sure how to push on this.

Please stay tuned, if you don't mind. I'll try to report back what's

happening.

>

> Hmmmmm interesting. I have Psoriatic arthritis and have had to

step up my meds for it this week. One of the options I was given was

Enbrel ...... no mention of it possibly not being compatible with the

Xolair. We ended up going the Metholtrexate injections route due to

the fact I have had decent results from it before and I also have had

discussions with my asthma dr that it could be beneficial there as

well so we are trying that first. In any case I go back to my

rheumatologist in 2 weeks so I will ask that specifically again.

>

>

> ----- Original Message ----

> From: <carrie72583@ ...>

>

> Sent: Wednesday, September 26, 2007 11:16:31 PM

> Subject: Re: [ ] Multiple Monoclonal Antibodies at Once?

>

> I met a respirologist who told me outright that xolair

was " expensive crap " . As treatments go, it is expensive and not

everyone has remotely close to any of the more " miraculous " results

described by our members.

>

> Enbrel is a monoclonal antibody to tumor necrosis factor alpha. It

is completely unrelated to IgE. As costly as xolair if not more. I

would have your new rheumy consult the patient assistance program to

see if they are compatible. To my knowledge, there are no studies

with ppl with such dual diagnoses on both meds.

>

> C

>

> ----- Original Message ----

> From: SD Designer <instdesgn1@ . com>

>

> Sent: Wednesday, September 26, 2007 4:02:59 PM

> Subject: [ ] Multiple Monoclonal Antibodies at Once?

>

> I saw a rheumatologist about a week ago who thinks I might have

psoriatic arthritis. Whatever - I'm sure hurting all over again. She

ordered around a dozen blood tests and several x-rays. Next week I'll

get the results. I will have to say that she was much more thorough

than most other docs have been, and especially rheumatologists.

>

> During our conversation I mentioned being on Xolair. She responded

wryly with " how much does it cost? " and " we can control that for $15

a month " (i.e., meaning using a completely different drug like a

steroid !!!) I was a little annoyed at the slightly cavalier attitude

and explained that I had had years of allergic asthma and infections

that had actually damaged my lungs. That subject was dropped,

however, she mentioned treating the arthritis with a monoclonal

antibody and that I could not be on both at once.

>

> I was wondering what is known about this? Xolair goes for the IgE

and is very different as I understand it than the drugs like Enbrel

(just for example) that must target a different immunoglobulin. So,

would it be possible to be on 2 different monoclonal antibodies at

the same time? Has anyone looked into this?

>

> I've heard that it's not uncommon for someone with asthma and

allergies to have arthritis. One dermatologist (who was quite snitty)

informed me that they see this a lot - unfortunately he didn't have

any cures or good suggestions, either.

>

> Thx!!!

>

> ------------ --------- --------- ---

> Building a website is a piece of cake.

> Small Business gives you all the tools to get online.

>

>

[Guest guest]

FYI....

The risk of major infection from enbrel is high because it blocks TNF-alpha. The

potential for serious infection is significantly higher than for xolair due to

the basic mechanism of what it is blocking. There are increased rates of

lymphoma with enbrel and remicaide. This has been shown in post-marketing trials

and appears on the front page of the website, which I am referring you to.

www.enbrel.com

You can get a re-exacerbation of latent TB, for example, so patients are usually

tested for it. My friend works in a non-clinical area of a hospital and she was

originally not considered due to her exposure to germs at work (despite not ever

seeing patients).

I have no idea how bad your arthritis is but enbrel is designed for the severe

end of the spectrum. My friend's rheumy offered to put her on enbrel 10 minutes

after she walked into his office for the first time. Doesn't sound Kosher to me.

Didn't sound Kosher to her either. I would be asking a lot of questions and make

sure, if I were you, that every other treatment modality was explored and

thoroughly tried.

Just my two cents especially if you are likely to be worried about potential

side effects.

(whose doctor did not put her on methotrexate because it causes liver

failure)

Ask a question on any topic and get answers from real people. Go to

Answers and share what you know at http://ca.answers.

[Guest guest]

To be considerering any of the below referenced treatments would suggest we are

talking about more then a few minor problems with arthritis and all side affect

need to be considered but to make a blanket statement such as methotrexate

causes liver failure is just a fear statement or should I say mis-statement.

Yes, if the dosage is wrong and your not properly monitored it can indeed have

drastic side effects as can alot of drugs but that is why they do liver function

test and monitor the dosage to minimize the chances of that happening. I have

previously been on methotrexate for 5 years and the higher end of the

recommended dosage for arthritis with no side effect and no liver effects.

I went to the infusion center today for my Xolair shot and I did ask my nurse if

they had anyone who was on both the Xolair and Enbrel and she was not aware of

any of her patients who were but it is a very small center and there are not

alot of us on Xolair. On the up side the infusion nurse seems to think I might

have a shot at convincing my Dr. to let me change to self injections for the

Xolair since I already do the methotrexate and have had lots of practice with

that. The only down side to that would be I'd probably end up with a co-pay for

the prescription that I don't have going to the infusion center.

----- Original Message ----

From: <carrie72583@...>

Sent: Monday, October 1, 2007 8:34:30 PM

Subject: Re: [ ] Re: Multiple Monoclonal Antibodies at Once?

FYI....

The risk of major infection from enbrel is high because it blocks TNF-alpha. The

potential for serious infection is significantly higher than for xolair due to

the basic mechanism of what it is blocking. There are increased rates of

lymphoma with enbrel and remicaide. This has been shown in post-marketing trials

and appears on the front page of the website, which I am referring you to.

www.enbrel.com

You can get a re-exacerbation of latent TB, for example, so patients are usually

tested for it. My friend works in a non-clinical area of a hospital and she was

originally not considered due to her exposure to germs at work (despite not ever

seeing patients).

I have no idea how bad your arthritis is but enbrel is designed for the severe

end of the spectrum. My friend's rheumy offered to put her on enbrel 10 minutes

after she walked into his office for the first time. Doesn't sound Kosher to me.

Didn't sound Kosher to her either. I would be asking a lot of questions and make

sure, if I were you, that every other treatment modality was explored and

thoroughly tried.

Just my two cents especially if you are likely to be worried about potential

side effects.

(whose doctor did not put her on methotrexate because it causes liver

failure)

Ask a question on any topic and get answers from real people. Go to

Answers and share what you know at http://ca.answers.

[Guest guest]

Dear Dawn et al.,

My statement about mtx and liver failure comes

directly from the mouth of my pulmonologist. I have a

very good friend who took Mtx for years with good

effect. Mtx is a potent immunomodulator with the

potential for very serious side effects. Liver

failure, even when patients are monitored,

unfortunately does occur.

I am glad to hear you have had no nefarious effects

from xolair or mtx and that your doctor is considering

home injection despite FDA recommendations to the

contrary.

C

Ask a question on any topic and get answers from real people. Go to

Answers and share what you know at http://ca.answers.

[Guest guest]

As I said, the mtx is prescribed by my rheumatologist. I trust his judgement

and monitor appropriately but following is what 's Hopkins has to say on the

subject as well, it still has a place in todays medicine. I'd have to assume

since you are in the Xolair users group you have chosen to accept the risk of

taking Xolair over the potential risk?

This is direct from 's Hopkins web site........

" Overall, Mtx is very effective and well tolerated. In fact remains the " gold

standard " disease modifying agent for RA despite the introduction of the newer,

very effective agents such as Remicade, Enbrel and Humira. Liver enzyme (blood

test) elevations are found in about 1% to 3% of patients, but these are

reversible if the drug is stopped. Liver failure is extremely rare. If patients

are on a stable dose of Mtx and have normal liver tests, I allow them to have 1

or 2 alcoholic beverages per week. Lung problems are also very rare, so rare its

difficult to give an exact number. I think most rheumatologists have had a few

cases, but small by comparison with the many patients on Mtx. You should discuss

with your doctor. But in patients with erosions on x-ray, in general, the

benefits of Mtx outweigh the risks. "

----- Original Message ----

From: <carrie72583@...>

Sent: Tuesday, October 2, 2007 10:55:57 PM

Subject: Re: [ ] Re: Multiple Monoclonal Antibodies at Once?

Dear Dawn et al.,

My statement about mtx and liver failure comes

directly from the mouth of my pulmonologist. I have a

very good friend who took Mtx for years with good

effect. Mtx is a potent immunomodulator with the

potential for very serious side effects. Liver

failure, even when patients are monitored,

unfortunately does occur.

I am glad to hear you have had no nefarious effects

from xolair or mtx and that your doctor is considering

home injection despite FDA recommendations to the

contrary.

C

Ask a question on any topic and get answers from real people. Go to

Answers and share what you know at http://ca.answers.

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[Guest guest]

Thanks, Dawn. Here's the latest at my end:

I saw my rheumy on Mon. I do not have the gene for psoriatic

arthritis but do have the other symptoms including pits in the finger

nails. Right now I'm in limbo re exactly which type of arthritis I

do have - she didn't know for sure. BUT she did say that I have to

go on treament for arthritis. Most or all of the lower end drugs

I've already tried or am allergic to. So, I chose methotrexate.

Because I'm on Xolair the rheumy insisted I talk to the pulmo first.

Also, methotrexate can cause lung damage BUT again, they give massive

doses of folic acid in advance of the methotrexate plus continue

w/the folic acid while on treatment. That seems to neutralize many

of the bad effects as methotrexate inhibits something that allows

absorption (production?) of folic acid.

My rheumy was VERY INTERESTED in communicating w/any other doctor who

has a patient on enbrel & xolair at the same time. I think you're

the closest I've come to so far! Thanks! Do you know if there are

other people out there who are or have been on xolair and

methotrexate at the same time? I'm intersted in hearing how you do

with Xolair. Is your doctor concerned about you being on both?

I've been on Xolair since March 23rd - shots every 2 weeks at home

self injecting w/no real problems. About 10-12 weeks into treatment

I convinced my pulmo that I should go from 300 mgs every 2 weeks to

375 mgs every 2 weeks (found copy of old IgE at 409) and that seemed

to be the boost I needed. Xolair has helped. It's not altogether

the " miracle " sensational cure I would like of course but I'm not as

bad off this horrible fall (lots of ragweed) as I was last year. My

hubby has noticed it too.

I'm in a lot of pain from arthritis - my shoulders really hurt and my

hips and knees hurt too. My tests for inflammation are sky-high but

as the rheumy pointed out, she doesn't know if that's from asthma or

arthritis. It's (inflammation) enough to cause serious cardiac

problems, though. I'm very concerned about the side effects and if I

do feel bad on methotrexate I will stop it. But, my husband is on a

potentially deadly med for MS and no one seems to bat an eye because

there aren't any other choices for him. I feel the same way - that

my choices are severely limited. My L5 and S1 (?) have fused

together on the left on their own causing more pain plus

deterioration. My mother is a semi-invalid. I don't want to be one

myself.

At the moment I'm waiting for my pulmo to get back from a

conference. She should read the reports I faxed sometime next week

and hopefully she'll give me some input about methotrexate from the

pulmonology perspective.

If you'd like, feel free to private email me.

Thanks so much for your interest.

>

> To be considerering any of the below referenced treatments would

suggest we are talking about more then a few minor problems with

arthritis and all side affect need to be considered but to make a

blanket statement such as methotrexate causes liver failure is just a

fear statement or should I say mis-statement. Yes, if the dosage is

wrong and your not properly monitored it can indeed have drastic side

effects as can alot of drugs but that is why they do liver function

test and monitor the dosage to minimize the chances of that

happening. I have previously been on methotrexate for 5 years and

the higher end of the recommended dosage for arthritis with no side

effect and no liver effects.

>

> I went to the infusion center today for my Xolair shot and I did

ask my nurse if they had anyone who was on both the Xolair and Enbrel

and she was not aware of any of her patients who were but it is a

very small center and there are not alot of us on Xolair. On the up

side the infusion nurse seems to think I might have a shot at

convincing my Dr. to let me change to self injections for the Xolair

since I already do the methotrexate and have had lots of practice

with that. The only down side to that would be I'd probably end up

with a co-pay for the prescription that I don't have going to the

infusion center.

>

>

> ----- Original Message ----

> From: <carrie72583@...>

>

> Sent: Monday, October 1, 2007 8:34:30 PM

> Subject: Re: [ ] Re: Multiple Monoclonal Antibodies at

Once?

>

> FYI....

>

> The risk of major infection from enbrel is high because it blocks

TNF-alpha. The potential for serious infection is significantly

higher than for xolair due to the basic mechanism of what it is

blocking. There are increased rates of lymphoma with enbrel and

remicaide. This has been shown in post-marketing trials and appears

on the front page of the website, which I am referring you to.

www.enbrel.com

>

> You can get a re-exacerbation of latent TB, for example, so

patients are usually tested for it. My friend works in a non-clinical

area of a hospital and she was originally not considered due to her

exposure to germs at work (despite not ever seeing patients).

>

> I have no idea how bad your arthritis is but enbrel is designed for

the severe end of the spectrum. My friend's rheumy offered to put her

on enbrel 10 minutes after she walked into his office for the first

time. Doesn't sound Kosher to me. Didn't sound Kosher to her either.

I would be asking a lot of questions and make sure, if I were you,

that every other treatment modality was explored and thoroughly tried.

>

> Just my two cents especially if you are likely to be worried about

potential side effects.

>

> (whose doctor did not put her on methotrexate because it

causes liver failure)

>

> Ask a question on any topic and get answers from real people. Go to

Answers and share what you know at http://ca.answers.

>

[Guest guest]

Thank, Dawn. My rheumatologist is also prescribing the methotrexate

and I have conifdence (she gave me choices re treatments) in her also

and have discussed the pros and cons.

The only gray area is the *combination* of methotrexate and xolair

together.

Yes, I've " accepted " the risks of Xolair and was no little bit

concerned. I still wonder about the long term side effects but

realize they could go either way.

Guess I'll find out in a week or so if my pulmo agrees re

methotrexate.

>

> As I said, the mtx is prescribed by my rheumatologist. I trust his

judgement and monitor appropriately but following is what 's

Hopkins has to say on the subject as well, it still has a place in

todays medicine. I'd have to assume since you are in the Xolair

users group you have chosen to accept the risk of taking Xolair over

the potential risk?

>

> This is direct from 's Hopkins web site........

>

> " Overall, Mtx is very effective and well tolerated. In fact remains

the " gold standard " disease modifying agent for RA despite the

introduction of the newer, very effective agents such as Remicade,

Enbrel and Humira. Liver enzyme (blood test) elevations are found in

about 1% to 3% of patients, but these are reversible if the drug is

stopped. Liver failure is extremely rare. If patients are on a stable

dose of Mtx and have normal liver tests, I allow them to have 1 or 2

alcoholic beverages per week. Lung problems are also very rare, so

rare its difficult to give an exact number. I think most

rheumatologists have had a few cases, but small by comparison with

the many patients on Mtx. You should discuss with your doctor. But in

patients with erosions on x-ray, in general, the benefits of Mtx

outweigh the risks. "

>

>

>

> ----- Original Message ----

> From: <carrie72583@...>

>

> Sent: Tuesday, October 2, 2007 10:55:57 PM

> Subject: Re: [ ] Re: Multiple Monoclonal Antibodies at

Once?

>

> Dear Dawn et al.,

>

> My statement about mtx and liver failure comes

> directly from the mouth of my pulmonologist. I have a

> very good friend who took Mtx for years with good

> effect. Mtx is a potent immunomodulator with the

> potential for very serious side effects. Liver

> failure, even when patients are monitored,

> unfortunately does occur.

>

> I am glad to hear you have had no nefarious effects

> from xolair or mtx and that your doctor is considering

> home injection despite FDA recommendations to the

> contrary.

>

> C

>

> Ask a question on any topic and get answers from real people. Go to

Answers and share what you know at http://ca.answers.

>

>

>

>

>

______________________________________________________________________

______________

> Tonight's top picks. What will you watch tonight? Preview the

hottest shows on TV.

> http://tv./

>

>

>

[Guest guest]

I've done a little research and from what I have found so far both 's

Hopkins and National Jewish Hospital use the combination so I guess one does not

preclude the other. I go back next week to my rheumatologist and will actually

see both Dr's so will discuss it further. The only thing I found was that

Genetec did not allow Mtx patients when they did their Xolair study but I

suspect that had more to do with it clouding how effective the Xolair was vs

what effect the Mtx was having on the patients. I will drop you a personal note

later this evening as I am at work now and don't have alot of time.

Dawn

----- Original Message ----

From: instdesgn1 <instdesgn1@...>

Sent: Wednesday, October 3, 2007 8:13:36 PM

Subject: [ ] Re: Multiple Monoclonal Antibodies at Once?

Thank, Dawn. My rheumatologist is also prescribing the methotrexate

and I have conifdence (she gave me choices re treatments) in her also

and have discussed the pros and cons.

The only gray area is the *combination* of methotrexate and xolair

together.

Yes, I've " accepted " the risks of Xolair and was no little bit

concerned. I still wonder about the long term side effects but

realize they could go either way.

Guess I'll find out in a week or so if my pulmo agrees re

methotrexate.

>

> As I said, the mtx is prescribed by my rheumatologist. I trust his

judgement and monitor appropriately but following is what 's

Hopkins has to say on the subject as well, it still has a place in

todays medicine. I'd have to assume since you are in the Xolair

users group you have chosen to accept the risk of taking Xolair over

the potential risk?

>

> This is direct from 's Hopkins web site........

>

> " Overall, Mtx is very effective and well tolerated. In fact remains

the " gold standard " disease modifying agent for RA despite the

introduction of the newer, very effective agents such as Remicade,

Enbrel and Humira. Liver enzyme (blood test) elevations are found in

about 1% to 3% of patients, but these are reversible if the drug is

stopped. Liver failure is extremely rare. If patients are on a stable

dose of Mtx and have normal liver tests, I allow them to have 1 or 2

alcoholic beverages per week. Lung problems are also very rare, so

rare its difficult to give an exact number. I think most

rheumatologists have had a few cases, but small by comparison with

the many patients on Mtx. You should discuss with your doctor. But in

patients with erosions on x-ray, in general, the benefits of Mtx

outweigh the risks. "

>

>

>

> ----- Original Message ----

> From: <carrie72583@ ...>

>

> Sent: Tuesday, October 2, 2007 10:55:57 PM

> Subject: Re: [ ] Re: Multiple Monoclonal Antibodies at

Once?

>

> Dear Dawn et al.,

>

> My statement about mtx and liver failure comes

> directly from the mouth of my pulmonologist. I have a

> very good friend who took Mtx for years with good

> effect. Mtx is a potent immunomodulator with the

> potential for very serious side effects. Liver

> failure, even when patients are monitored,

> unfortunately does occur.

>

> I am glad to hear you have had no nefarious effects

> from xolair or mtx and that your doctor is considering

> home injection despite FDA recommendations to the

> contrary.

>

> C

>

> Ask a question on any topic and get answers from real people. Go to

Answers and share what you know at http://ca.answers.

>

>

>

>

>

____________ _________ _________ _________ _________ _________ _

____________ __

> Tonight's top picks. What will you watch tonight? Preview the

hottest shows on TV.

> http://tv.. com/

>

>

>