Tamiflu

Did you know that Tamiflu isn’t just used to treat confirmed influenza?  If you’ve been exposed, Tamiflu can be taken to prevent the flu (or at least minimize symptoms) after you’ve been exposed.

016As a person on multiple immunosuppressant drugs, flu season is not my favorite time of year.  I get my influenza vaccine hoping to stay healthy, but the shot is only about 60% effective, and the world is full of people who don’t understand how irresponsible it is to contribute to the spread of preventable disease.  $35 to greatly reduce my chances of dying from the influenza seems like a bargain.

A few days ago I was exposed to what was a few hours later confirmed to be influenza A.  This, I determined, was a situation worthy of skipping both my biologic and mtx.  My doctor determined that it was also worthy of a round of tamiflu.  With known exposure, tamiflu can be used to prevent the flu — or at the very least, make the case less severe than it would otherwise have been.  I had not known that Tamiflu could be used prophylactically.

If you are exposed to a confirmed case of the flu, there’s no need to spend any time worrying about whether or not you’ll get sick.  Talk to your doctor.

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How Flu Spreads
Tamiflu

New Oral RA Med

Yesterday, the FDA approved Pfizer’s XELJANZ (tofacitinib) for treatment of RA when methotrexate has failed to work adequately.  This oral medicine is in a new class of drugs:  Janus kinase (JAK) inhibitor.

Another JAK, ruxolitinib, was approved last year for the treatment of myelofibrosis.  Other JAK inhibitors are being tested as treatments for psoriasis, RA, and some cancers.  I have to admit that reading about JAKs made my eyes glaze over; all I retained was “just another kinase” having to do with cytokine receptors and “named after the two-faced Roman god Janus.”   Perhaps Andrew will write something comprehensible for us laymen (hint).  Until then, I know which reading material I’ll select next time insomnia strikes.

Tofacitinab comes with the black-box warning that RA patients are all too familiar with:  elevated liver enzymes, lower blood counts, high cholesterol, and increased risk of infection, tuberculosis, lymphoma, and cancers.  Post-marketing studies were ordered, so time will tell how effective this medication is, and whether there are other side effects to watch for.  Those who have run the gauntlet of every available medicine but found no relief now have a new treatment option.

See Medscape’s article here, and the FDA’s approval letter here.

Without Fear

“Are those injections you give yourself involved in the meningitis outbreak?!” asked a caller over the weekend.  Sometimes it’s really nice to have people who care enough to check on you.

Since I don’t give myself steroid shots, I haven’t been concerned, but had to admit that I wasn’t even sure which drug was in question.  A quick search brought the answer:  methylprednisolone acetate (Depo Medrol) – the steroid favored by my rheumatologist and orthopedist.

That raises more questions for me.  Is meningitis only a problem when the tainted drug is injected into the spine?  What if it’s injected into shoulders, hips, knees, or other joints?

Then again, it’s idle curiosity.  I haven’t had any steroid shots since July, but if I had, and it was at one of the clinics that bought the bad drug, I might be making an appointment to ask my doctor these questions.  Some of you, my cyber friends, might have gotten steroid injections in the past few months, though, and might be more than a little alarmed at the recent headlines.

The CDC has published a list of clinics.  Nobody need wait in fear, wondering if they’ll be stricken next.

Credit: CDC