Johns Hopkins Arthritis Center

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H1N1 vaccine and RA treatment

My wife (age 62) has had moderate to severe RA for 10 years. Symptoms have been largely alleviated in the past 8 months by concomitant biologic treatment (Humira) with methotrexate (25 mg). Previous treatments, including Enbrel/MTX and Orencia/MTX all had some success but ultimately failed. She has been taking seasonal influenza vaccinations every year since 2002, including this year. She wishes to get immunized for H1N1 with unadjuvanted vaccine, but it is not clear whether she can do so here in Canada, where only limited amounts of unadjuvanted vaccine are available, and which are targeted for pregnant women only. The adjuvanted vaccine, produced by GSK, contains the adjuvant AS03, made up of squalene, vitamin E and Polysorbate 80. It also contains 1/5 of the amount of antigen contained in the unadjuvanted vaccine. What are the known and unknown risks of this adjuvant, and would she be wise to forego the H1N1 vaccinations altogether? What are the chances that she already has some immunity to H1N1? She is concerned that the adjuvant might trigger further uncontrolled auto-immune responses. She is also very nervous to venture out in public without a face mask and hand sanitizer for fear of contracting H1N1 flu. Her family doctor (new) and rheumatologist have been unable to offer any definitive advice.

Humira and Pregnancy

Re: Humira and Pregnancy I know that most doctors advise their patients who are planning to get pregnant to stop taking Humira since no long-term studies have been done. In your view what is the appropriate amount of time I should be off the drug before conception? My rheumatologist is suggesting 3 months, which sounds quite conservative to me. Isn’t it out of my body well before then? Thanks.

Hard to swallow big pills

I have a problem swallowing large pills how big are the predisone pills and can they be broken up?

Fibromyalgia and ‘knots’

Hello, I was wondering if Fibromyalgia affected only women. I am a man, for the last few years i’ve noticed small knots around my body….thighs, behind knee, arms, some on back near spine. Last year on the back of my legs got bad, really bad, left leg behind knee along tendon knots, lots of them could hardly walk, went to doctor, sent me for blood, x-rays and blood flow tests, all came back good, by the time I had went through all that and with some heavy hitting pain meds, the knots subsided and reduced in swelling, I wanted an MRI, my doctor didn’t, said it had gotten better and we’ll keep an eye on it. The knots are still there and it does restict movement at times with pain, but now i’m getting lots of knots on my right forearm with pain. Is this a form of Fibromyalgia or not enough water. My doctor had prescibed to me at first to bike ride, swim and stretch as much as possible, 2 days later I almost passed out from the pain and obviously he said to then relax the leg.