The COVID Vaccines and Autoimmune Disease
As the COVID vaccine rolls out, people with arthritis and other autoimmune diseases are wondering what this means for them. Is the COVID vaccine safe if you’re taking immunosuppressants, like methotrexate, Humira, Enbrel, and other biologics? Does it work? We don’t have all the answers to these questions, unfortunately. The vaccines are too new, and they haven’t been fully tested on immunocompromised people. That doesn’t mean we can’t find some guidance, though. So, what do we know so far about the COVID vaccine for people with autoimmune diseases? (I am not a doctor, and more importantly, I and others on the internet are not your doctor. Each person is unique,…
First Biologic Medications Approved for nr-ax Spondyloarthritis
After years of waiting, patients with non-radiographic axial spondyloarthritis (nr-axSpA) can officially be prescribed biologic medications in the US. Since the beginning of the year, three biologic medications have been approved by the FDA for people with nr-axSpA: Cimzia, Taltz, and Cosentyx. As someone who spent years waiting for diagnosis and treatment, I’m excited by the game-changing potential of nr-axSpA treatments being officially recognized. nr-axSpA? Spondyloarthritis (SpA) is a group of autoimmune arthritis conditions that affect the spine, other joints, and entheses. Ankylosing spondylitis (AS) is the most well-known (and easily diagnosed) type, but it requires joint damage to be visible on imaging. This leaves doctors with a conundrum: how…
We don’t know if hydroxychloroquine is safe for COVID
Hydroxychloroquine (and related drug chloroquine) has been in the news a lot lately for its supposed ability to cure or prevent COVID-19. These drugs are commonly used to treat autoimmune diseases lupus and rheumatoid arthritis, especially under the brand name Plaquenil (hydroxychloroquine). This leaves those of us with autoimmune conditions wondering: could I be taking hydroxychloroquine to both treat my autoimmune disease and prevent coronavirus? In a time when taking immunosuppressants is unnerving, is hydroxychloroquine a safe treatment? If I’m not on hydroxychloroquine, should I start taking it? The short answer is no. The long answer is that a lot of studies are showing contradictory results, and the small study…
COVID-19 and immunosuppressants: new data
Since COVID-19 is so new, there’s a shortage of important information on how it affects people with autoimmune disease. Many of us have asked our doctors for guidance with our conditions and medications, but in the end, no one really knows how COVID-19, autoimmune diseases, and immunosuppressants interact. We need data and cases to truly understand how we should proceed. We don’t yet have any large-scale studies, but a small study from New York was released this week in the New England Journal of Medicine. It can give us some much-needed insight into how coronavirus impacts those of us who have autoimmune diseases and take immunosuppressants. Where my last article…
Coronavirus and biologics: Some good news?
The current coronavirus pandemic is concerning, but it can be especially so for people who take immunosuppressant biologics, including TNF and IL-17 inhibitors. Medications like Humira, Enbrel, and Cosentyx are known to suppress the immune system—after all, that’s how they stop autoimmune disease. Does taking these medications put someone more at risk for coronavirus? There’s a lot of information out there, and nothing is conclusive, but I’m going to share what I’ve seen. Some of it has even reassured me! For an updated report from 5/2/20, see COVID-19 and immunosuppressants: new data. It provides data on biologics, oral steroids, methotrexate, and Plaquenil. For current research on Plaquenil, see We don’t…
The cool engineering behind Xeljanz XR
My doctor mentioned this, and the engineer in me thought it was extremely cool. So here’s how they got Xeljanz XR to work properly, so that it’s a once-daily pill instead of twice-daily: they coated it and put a hole in the end! What is Xeljanz? Xeljanz XR (for “extended release”) is a once-daily pill used to treat rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis. It’s also being tested for ankylosing spondylitis currently. You may know it from its aggressive marketing campaign. The makers are really pushing the fact that it’s a pill, not an injection like many other similarly effective arthritis medications (biologics). Though not technically a biologic medication,…
Does CBD work?
Using CBD (cannabidiol) for pain, insomnia, anxiety, depression, and countless other conditions has become popular. A lot of people use CBD oil, which comes in a little dropper bottle and often includes some (rather arbitrary) dosing instructions. CBD also comes in pills and gummies and can be vaped. It’s so easy to get, but does it work? Is it safe? What is CBD? CBD is an extract of the hemp plant, the same plant that marijuana comes from. Hemp can be used for a lot more than marijuana, though, and contains many different called cannabinoids, including CBD. CBD and other chemicals can be extracted from hemp in ways that keep…
Biologics explained
Biological medicines, or biologics, get talked about a lot. The word is casually thrown around in the rheumatology world by doctors and patients alike. What can get skipped, though, is an explanation of what, exactly, makes a biologic a biologic, and why biologics are different from other drugs. What is a biologic? A biologic medication is a medication that comes from a living source. The drug is produced by living cells and then used as medicine. This is different from traditional medications, like aspirin, Tylenol, or ibuprofen, which can be made by carefully combining chemicals (I’ve even made aspirin myself in lab class). Because of how biologics are made, the…
Biosimilars: What’s the buzz?
I’ve been hearing a lot about biosimilars lately. On Twitter, at the ACR conference, from pharmaceutical companies and physicians, they’re popping up more and more. In the United States, they’re just starting to get approval and reach patients, while in Europe, they’re gaining ground and making biologic medications more affordable. But what does it mean if something is a biosimilar? Are they safe and effective, and how available are they? What are biosimilars? Many drugs today have both brand-name and generic versions available for use (Advil and Motrin vs. generic ibuprofen, for example). This is because when a drug is first developed, the developer applies for a patent protecting their…
Humira, Enbrel, and cancer risk
There’s a scary warning when you read about biologics like Humira and Enbrel: these drugs may increase risk of cancer. Scarier, Humira has a warning that it may cause a rare, deadly type of cancer in young people. After spending many bored hours in doctor’s offices, I’d read the warnings many times on pamphlets and posters. Probably too many, because it made me question whether it was the right choice to start a biologic therapy when my doctor offered it as an option. Simply put, biologic medications are drugs that are made from living sources, instead of mixing chemicals. They include medicines like Humira and Enbrel for autoimmune diseases and even…
