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If i have rheumatoid arthritis and i’m using biological treatment, can i stop biological treatment someday? this is a question that many rheumatoid arthritis patients will ask. what is the answer to this question? first of all i would like to clarify, why do we start biological treatment for patients with rheumatoid
Arthritis? when we prescribe treatments for patients with rheumatoid arthritis we either use non-biological treatments.. we call them the conventional dmards or we use biological treatments.. we usually start with the non-biological treatments. we have more experience with them, they are effective enough in many
Patients.. not all but many patients a state of remission, but if this doesn’t happen we go for the biological treatments which are more potent than the non-biological ones. treatments is that they are very expensive. if you don’t have money and if you don’t have insurance, you have a problem availing those
Assume that they must have severe side effects that would prevent continuing those treatments so treatments are more potent treatments than many adverse effects than the non-biologicals. they are very comparable. the profile of the side effects is very comparable between both entities. the disease? if i receive one
Or two shots of treatment this is the end of my disease? this is one question . the second question, am i going to be on this medication for life or there this is not a final treatment. this is not the end of the disease. this is not a course and that’s it. continuous treatment, but with some exceptions
And am i going to be on that treatment for good? theoretically, you should be on treatment for good, but practically there is a chance that we might stop, decrease the dose or stop that treatment someday. how? if you improve on the treatment whether biological or non-biological even, if you improve on the
Treatment, what the doctor will do is that he will start to decrease the doses of your medication and if all goes well and you’re tolerating this and there’s no activity of the disease that is emerging with this decreasing of the doses of the treatment, we decrease further and we keep on decreasing further
So long as it is tolerated, and if conditions are under control we will consider stopping the nothing happens, everything is under control you then you never get a flare again, as if you are cured of the disease, as if you’re cured of the disease. this video is about when and how the doctor will decrease the biological
Treatment. if you feel better on the treatment then the doctor will start to have a plan to decrease doses of treatments in general. what is the definition of the patient has improved on treatment? for the patient, it means i feel better, but for the doctor things are more organized than that. for me, as a doctor, it
Means that the severity of the pain that you feel is less, the stiffness of the joints in the morning is less, on examination joint counts are less and the lab parameters, we have a station called low disease activity and it means certain figures of improvement are normal. okay if the patient improved,
According to what doctors classify according to the criteria of doctors and he was on a biological treatment what are we going to do now? first of all, if you are on cortisone, if you are on prednisolone or corticosteroids, this is the first thing that we remove from our way, we decrease the hoping that we can stop it
Completely, if the patient is on steroids. after that we start to consider the biological treatment. how we can decrease it. the non-biological treatment if it is also prescribed to the patient we don’t consider this now we just think of the biological treatment nowdecreasing the biological treatment doses. at a
Time when we, doctors, we have rules and for increasing the doses of medications, we don’t have really strict or clear rules for decreasing the doses of medications specially experience of the physician and, or the sporadic phyisicans who have the same experience. when we the distance between the doses or we
Decrease the dose of one individual shot of the treatment. increase the space instead of 7 days to 9 days, and if all goes well, we go to 11 days. if all goes well, we go to two weeks maybe. all goes well also has to be many weeks, two months, three months, it has to be duration, we don’t just keep on escalating
The distances. if you are maintaned on a treatment that you receive every two weeks, of two weeks, you will go nt for 17 days, then 19 days, then 3 weeks, maybe more. if you are on a treatment that you receive every month, also sometimes, we make it every 5 weeks, we makes it every 7 weeks and 2 months and so
On. decreasing the dose in an individual doctors in the strategies of decreasing biological treatments. some of them will increase the distance between the two doses and some of them will go for decreasing the that it is much much safer to increase the distance between the doses but always keep the dose the
Same, as it is, without decreasing it. in the ability.. in how far you can reach.. when you go for spacing out. sometimes you have a ceiling that you cannot exceed like, there is an injection that you receive every two weeks.. 19 days. for other patients you can keep on doses, until eventually you stop the
Medication. out or decreasing the doses on your own at all. this is something that should be done through your doctor because the assessment of than the assessment of the patient always.
Transcribed from video
Can rheumatoid arthritis patients stop biologic medications? Part 1 of 2. Dr. Hatem Eleishi By Online Medical Consultations