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Can rheumatoid arthritis patients stop biologic medications? Part 1 of 2. Dr. Hatem Eleishi

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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.

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Can rheumatoid arthritis patients stop biologic medications? Part 1 of 2. Dr. Hatem Eleishi By Online Medical Consultations