Arthritis means inflammation or swelling of one or more joints. It describes more than 100 conditions that affect the joints, tissues around the joint, and other connective tissues. Specific symptoms vary depending on the type of arthritis, but usually include joint pain and stiffness.
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Biosimilars for the Treatment of Rheumatoid Arthritis
Biosimilars are medications that we use to treat rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis. These are proteins that we inject under the skin or we have to infuse them through an IV. The reason we have to do that is they are proteins – you can’t swallow them because they would be digested. So very different from traditional medications that we use for rheumatoid arthritis.
Biosimilars are very similar types of medications, they have the same protein structure as original biologics. The difference is because they are a large molecule, in the manufacturing process there may be some minor changes in the structure of the protein. As a result we need to make sure that these biosimilars have the same efficacy and no increase in side effects of the medications.
Biosimilars have to go through a kind of similar kind of registration process that the biologics have, so they need to go through a process where the FDA in the United States and Health Canada here looks at these medications, and appropriate studies are done to ensure that they’re as safe and effective as the original biologic.
The big advantage of the biosimilars or the biologics is the price. They’re going to be less expensive than the original biologics. The expectation in rheumatoid arthritis patients is they would receive the same range of services as if they would have received the same biologic. Seeing a local family physician or a local physiotherapist can help with inflammation and fatigue. Seeing a registered Dietician for advise on foods that cause inflammation could help.
Those services would include access to infusion clinics if they needed infusion, some financial assistance, assistance with the pharmacy and other assisstancies they might need. In treating rheumatoid arthritis with the biosimilars, you want to make sure you check with your rheumatologist, and perhaps your pharmacist, to make sure it’s the right medication for you. Presenter: Dr. John Wade, Rheumatologist, Vancouver, BC
What is Polymyalgia Rheumatica?
Polymyalgia rheumatica is a systemic inflammatory condition. It's a relative of rheumatoid arthritis. It has slightly different characteristics, which I'll describe to you.
Polymyalgia rheumatica generally is a disorder in individuals over the age of 60. It's very rare to see people under the age of 50 with polymyalgia rheumatica. &
It's a disorder that comes on fairly abruptly, where one will suddenly have onset of pain and stiffness, generally about the shoulder and hip girdle, extending into the upper arms, extending into the thighs and the back of the legs. It comes on almost within a week or two.Often, some patients will say it comes on within a day where they felt very painful, stiff, sore, had a difficult time getting out of bed, getting up stairs. Most will describe improvement through the day. As they get up and carry out their activities of daily living, things will become less and less.
There may be associated symptoms because it's a systemic condition. It can also present with constitutional symptoms. Many patients will state that, for two or three weeks before the onset of musculoskeletal symptoms, they'll begin to lose weight, feel tired, sometimes have a low-grade fever. If you feel you have this condition and have symptoms that suggest the possibility that polymyalgia rheumatica may be a disorder affecting you, the most important thing is to seek medical attention with your primary care physician. He or she will run a number of tests, as well as interview you and see whether this may be relevant to your case. Most patients with polymyalgia rheumatica will be referred to a specialist thereafter. Presenter: Dr. John Watterson, Rheumatologist, Victoria, BC