Tuesday, September 01, 2009

Outpatient Medications for Autoimmue Conditions: Remicade, Humira, Tysabri--Sources for Patient Information and Support

Treating Autoimmune Conditions

Most of the time our immune system protects us from invaders from outside of our body, whether they may be in the form of a virus, bacteria, fungus, or even a tumor. In the worst case scenario, a "glitch" causes the immune system to overreact.  A damaged and confused immune system attacks healthy organs or tissues resulting in an autoimmune disorder such as multiple sclerosis, type 1 diabetes, inflammatory bowel disease, or rheumatoid arthritis.

Suppressing the immune system is a means of controlling an autoimmune disease, but the consequences of doing so (the risk of life-threatening infection) makes this an obviously unreasonable regimen. In seeking answers to this dilemma, scientists developed Monoclonal Antibody Immunotherapy. In this therapy, antibodies created outside the body are given as an injection or intravenous drug. Some monoclonal antibody infusions are used in conjunction with chemotherapy to treat certain types of cancer. In recent years, monoclonal antibodies targeted at major autoimmune illness have been introduced to treat conditions such as Multiple Sclerosis, Plaque Psoriasis, Rheumatoid Arthritis, Crohn's Disease, Ulcerative Colitis, or Ankylosing Spondylitis.

Hospitalization is not required for infusion of most monoclonal antibodies. Two of the major autoimmune therapies, bi-monthly Remicade and monthly Tysabri, are given by intravenous drip in closely monitored outpatient settings such as infusion clinics or doctor's office. Humira, a (sometimes weekly) subcutaneous injection, is given in an outpatient setting or is self-administered by the patient at home.

Patient Resources for Monoclonal Antibody Therapies

It's important to understand that although these drugs often work well in controlling the symptoms of specific autoimmune disorders, there are definitely risks that must be considered. In an effort to educate and provide support to their patients, the manufacturers of Remicade, Humira, and Tysabri have developed websites for their benefit.
Avoid Serious Consequences

Carefully read the patient information regarding these drugs and heed the warnings given in order to avoid serious, life-threatening complications. Knowing what to expect from your treatment and what symptoms to promptly report to your physician is essential in ensuring good results with these medications.

Personal Thoughts

I've had experience administering each of these medications in an infusion center where I worked. It was pleasing to see real improvement and enhanced quality of life in many patients. Each of these drugs is certainly capable of producing (usually mild) allergic-type reactions during administration. Each of these drugs also carries the risk of developing other complications. Please don't disregard the brochures and patient information handouts you receive regarding these (or any) medications.

Want to Read More? I found this interesting:

Peakman, M. & Daylan, C.M. (2001). Antigen-specific immunotherapy for autoimmune disease: fighting fire with fire?. Immunology, December; 104(4): 361–366.
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Unknown said...

I missed a collection and had to restart. And I washed out my jug with just water. Will this alter my results?

Carolyn Cooper, MPH, RN said...

Check with the lab that provided your collection jug. If the jug contained preservatives, you could have altered results without them.

Anonymous said...

Hello Carolyn, first off you are an absolute gem for taking your personal time to answer all these questions. You have helped so many. My question is: my husband is doing a 24hr urinw test for elevated dopamine levels ( catecholamines) can we still have sex while doing the test concidering semen may still b in the urithra while urinting afterward. Also I read this test can be affected by your state of mind. During sex obviously and climax ones state of mind can get be altered. What do u think?? I'm not just trying to get out of it, I think it's a valid question . Can u help us out?

Carolyn Cooper, MPH, RN said...

Dear Anonymous, This is a great question . . . I think that deferring sexual intercourse during this 24 hour urine collection for catecholamines is not a bad idea. You are exactly right that vigorous exercise, activity, and emotional (stress) can affect the outcome of this particular test. There are also food and medication that need to be avoided for several days prior to this test. You will find that information in the blog, and it should be specified on the information sheet the lab provides to you. Good luck with the test!!