TB and biologics???

[Guest guest]

Hi, I hope everyone is having a good Mothers Day.I have a question

about TB and Orencia.At 15yrs old I tested pos.for TB.I was told that I

didn't have the disease,but had come into contact with it.When I was

dx. with RA,my rheummy sent me to an Infectious Disease specialist.He

had me take 12 mths of antibiotics as treatment for TB,this should have

been done 40 years ago,but it wasn't.Now this month I am suppose to

start Orencia.I have researched TB and have found that the treatment I

was given is standard.I just wonder,does the treatment protect me from

getting active TB if I am on biologics? and if (God forbid) I do get

it,what then? My rheummy is aware of all of my concerns and says I have

to decide if the benefits out weighs the risks.I don't think I know how

to do that.I hate the RA and all of its evil little friends,but do I

need active tuberculosis as well? If anyone has advice or knows where I

could find some answers,please let me know.Thanks,Sherry

[Guest guest]

Sherry, what was the result of your most recent TB test?  Did your arm get

bumpy?

[ ] TB and biologics???

Hi, I hope everyone is having a good Mothers Day.I have a question

about TB and Orencia.At 15yrs old I tested pos.for TB.I was told that I

didn't have the disease,but had come into contact with it.When I was

dx. with RA,my rheummy sent me to an Infectious Disease specialist.He

had me take 12 mths of antibiotics as treatment for TB,this should have

been done 40 years ago,but it wasn't.Now this month I am suppose to

start Orencia.I have researched TB and have found that the treatment I

was given is standard.I just wonder,does the treatment protect me from

getting active TB if I am on biologics? and if (God forbid) I do get

it,what then? My rheummy is aware of all of my concerns and says I have

to decide if the benefits out weighs the risks.I don't think I know how

to do that.I hate the RA and all of its evil little friends,but do I

need active tuberculosis as well? If anyone has advice or knows where I

could find some answers,please let me know.Thanks, Sherry

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[Guest guest]

The skin test(PPD) I think it's called,is injected just under the skin on the

inside of the forearm.Mine always turned red,was swollen and raised.I had to

return to the MD office 24 hrs later and have the reaction checked.It was very

positive.The nurse took measurements of the site and put that in my records. I

have had the very same reaction every time I've been tested,(my first was in

1965) I really don't understand why no one ever put me on treatment. I was

considered to have Latent TB.(non active) The research I've done on TB doesn't

mention reactiveation with biologics,and the biologics sites don't mention

" treated " TB.Got any ideas?Thanks,Sherry

[Guest guest]

Hello Sherry,

Hope I can help a bit. All this is very complicated. Also I apologise if this

message does not travel well across the pond from the UK, I see one of my other

postings had extra symbols!! Oh dear,sorry. By the way I'm writing as a retired

doctor, and I am in this group on behalf of a friend who has bad RA and no

computer access.

Your positive skin tests showed that you had already developed

healthy immunity  by 1965  presumably by having exposure and reaction

unknowingly to TB bacillus. Probably a chest X ray would have been asked for

just to check that there was no sign of activity.Then you would have been

reassured and just told you did not need BCG. Often but not always the X ray

 might show a tiny calcified sign in the lung that TB bug had been 'seen

off' without any problem and that would not be cause for any concern at all.

In the olden days that finding would be a hallmark of all the healthy associates

and relatives of someone ill  with TB. It was normal. They developed a

natural body resistance by mounting an immune response. No treatment would be

needed.

The possible problem is only rarely  when the body defences are damped down

later either by debilitating illnesses, or intentionally as with the

biologics.That is why the screening test you had done is so important before

starting treatment of that kind.

 It is as a little like shingles that can occur from dormant Herpes zoster

virus in the body years after having  chickenpox as a child , when the immune

system is damped down, even though in between it never caused any problem at

all.That is what latent, non active, means.There is a possibility of being

reactivated if the balance is upset. 

Think there is some very good recent evidence just coming  out now of trials

of people being treated with biologics successfully after having

protective treatment for the latent TB first, but that is obviously where you

need to discuss your own case with your specialist to weigh up pros and cons for

you.

Hope this helps

Good luck Sherry

from Chris

[ ] Re: TB and biologics???

The skin test(PPD) I think it's called,is injected just under the skin on the

inside of the forearm.Mine always turned red,was swollen and raised.I had to

return to the MD office 24 hrs later and have the reaction checked.It was very

positive.The nurse took measurements of the site and put that in my records. I

have had the very same reaction every time I've been tested,(my first was in

1965) I really don't understand why no one ever put me on treatment. I was

considered to have Latent TB.(non active) The research I've done on TB doesn't

mention reactiveation with biologics,and the biologics sites don't mention

" treated " TB.Got any ideas?Thanks, Sherry

[Guest guest]

Sherry,

The year of antibiotics was given to you to try to eradicate the latent TB.

That should greatly reduce the chance that you will develop active TB.

Unfortunately, there isn't much information about Orencia (abatacept) and TB

reactivation yet since it is much newer than the better-studied anti-TNF

biologics.

I'll post what I can find related to this separately.

Not an MD

> [ ] TB and biologics???

>

> Hi, I hope everyone is having a good Mothers Day.I have a question

> about TB and Orencia.At 15yrs old I tested pos.for TB.I was told that I

> didn't have the disease,but had come into contact with it.When I was

> dx. with RA,my rheummy sent me to an Infectious Disease specialist.He

> had me take 12 mths of antibiotics as treatment for TB,this should have

> been done 40 years ago,but it wasn't.Now this month I am suppose to

> start Orencia.I have researched TB and have found that the treatment I

> was given is standard.I just wonder,does the treatment protect me from

> getting active TB if I am on biologics? and if (God forbid) I do get

> it,what then? My rheummy is aware of all of my concerns and says I have

> to decide if the benefits out weighs the risks.I don't think I know how

> to do that.I hate the RA and all of its evil little friends,but do I

> need active tuberculosis as well? If anyone has advice or knows where I

> could find some answers,please let me know.Thanks,Sherry

[Guest guest]

Enbrel Gets " Black Box " Warning

Biologic Drug's Infection Risk Warning Strengthened to " Black Box "

Warning

http://arthritis.webmd.com/news/20080501/enbrel-gets-black-box-

warning?ecd=wnl_art_051208

Sue

On Tuesday, May 13, 2008, at 01:21 PM, sherry elkins wrote:

> The skin test(PPD) I think it's called,is injected just under the

> skin on the inside of the forearm.Mine always turned red,was swollen

> and raised.I had to return to the MD office 24 hrs later and have the

> reaction checked.It was very positive.The nurse took measurements of

> the site and put that in my records. I have had the very same reaction

> every time I've been tested,(my first was in 1965) I really don't

> understand why no one ever put me on treatment. I was considered to

> have Latent TB.(non active) The research I've done on TB doesn't

> mention reactiveation with biologics,and the biologics sites don't

> mention " treated " TB.Got any ideas?Thanks,Sherry