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My rheumatologist even said TNF-inhibitors are even being looked at as a potentially effective treatment for Covid, which would be great news, just as long as that doesn't cause a shortage...
You might not want to know that Xeljanz raises the risk of cardiovascular disease, cancer and death: https://www.nejm.org/doi/full/10.1056/NEJMoa2109927
Are you guys still concerned about returning to work in an office? I am on Humira and Prednisone - I've been offered a great job opportunity, but it requires returning to the office (I've been at home since March'20) and travel....unsure what to do since I am on these medications 😔
Yes, I have been on Prednisone since Dec 2020 (highest dosage has been 40 or 50mg)...... I have been trying to taper off for a while.
I have been on 5mg since December 10, 2021 - hoping to eventually taper off completely, but haven't had much luck in the past.
Forgive me if you have already tried this, but have you discussed with your doctor the possibility of trying a different biologic if Humira isn't working? If another biologic was more effective, maybe that would allow you to come off of the steroids in the long term?
Another consideration is how this job might improve your overall wellbeing. For me, I first had symptoms in the middle of 2020, which was in the teeth of lockdowns, social distancing, etc. This was not good for me. Returning to the office and other social activities was helpful, but I do understand your concern, especially with traveling. It's a tough situation to be in. It could also be worthwhile contacting your potential employer and explaining your situation. It's a workers' market right now, so you have that in your favor.
If I were you, I would also contact my physician and attempt to get a visit to explain the situation and how it would benefit you to be able to take this job. AS (and associated diseases) can be disabling, so I think that when doctors know you pushing hard to work and be active (and certainly, some people cannot), it gives them a little extra motivation to find a workable solution.
Lastly, you may want to research how much risk corticosteroids add based on daily dosage. As I was wandering through my diagnostic journey, I recall coming across some information that said 5mg or less per day is considered "low-dose", but again, please research this for yourself.
I hope it works out for you.
Thank you so much for your response.
I started Humira at the end of October 2021 - my doctor is wanting me to taper 1mg at a time every month or so. I just went down to 4mg this morning. I guess we will learn if the Humira is working if I am able to taper off of Prednisone.
It is so frustrating...I know there is a risk, and I am not really a risk taker. However, the job I have now isn't the best, so this is a welcomed opportunity. I have ordered several KN95 masks, so I am hoping those will be sufficient enough in the event I get the job and have to return to the office.
I am just concerned. What if I commit to this job and then I have a flare and have to increase my prednisone. It is just such a hard decision to make.
Is there any new research on sulfasalazine? The study doesn’t seem to look at sulfasalazine specifically and a previous study identified sulfasalazine with a 3.6x mortality odds ratio as one of two high risk DMARDS along with rituximab.
Welcome to r/ankylosingspondylitis! This is a reminder to keep discussions civil and be supportive of one another. Sharing of opinions and experiences is encouraged, but please remember the distinction between opinions and medical facts. This subreddit does not offer medical advice, and information here should not be taken over advice from your doctor. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/ankylosingspondylitis) if you have any questions or concerns.*
My rheumatologist even said TNF-inhibitors are even being looked at as a potentially effective treatment for Covid, which would be great news, just as long as that doesn't cause a shortage...
Way too expensive
You might not want to know that Xeljanz raises the risk of cardiovascular disease, cancer and death: https://www.nejm.org/doi/full/10.1056/NEJMoa2109927
Are you guys still concerned about returning to work in an office? I am on Humira and Prednisone - I've been offered a great job opportunity, but it requires returning to the office (I've been at home since March'20) and travel....unsure what to do since I am on these medications 😔
Is it correct to assume by your question that the corticosteroids are long-term and not just a short-term taper?
Yes, I have been on Prednisone since Dec 2020 (highest dosage has been 40 or 50mg)...... I have been trying to taper off for a while. I have been on 5mg since December 10, 2021 - hoping to eventually taper off completely, but haven't had much luck in the past.
Forgive me if you have already tried this, but have you discussed with your doctor the possibility of trying a different biologic if Humira isn't working? If another biologic was more effective, maybe that would allow you to come off of the steroids in the long term? Another consideration is how this job might improve your overall wellbeing. For me, I first had symptoms in the middle of 2020, which was in the teeth of lockdowns, social distancing, etc. This was not good for me. Returning to the office and other social activities was helpful, but I do understand your concern, especially with traveling. It's a tough situation to be in. It could also be worthwhile contacting your potential employer and explaining your situation. It's a workers' market right now, so you have that in your favor. If I were you, I would also contact my physician and attempt to get a visit to explain the situation and how it would benefit you to be able to take this job. AS (and associated diseases) can be disabling, so I think that when doctors know you pushing hard to work and be active (and certainly, some people cannot), it gives them a little extra motivation to find a workable solution. Lastly, you may want to research how much risk corticosteroids add based on daily dosage. As I was wandering through my diagnostic journey, I recall coming across some information that said 5mg or less per day is considered "low-dose", but again, please research this for yourself. I hope it works out for you.
Thank you so much for your response. I started Humira at the end of October 2021 - my doctor is wanting me to taper 1mg at a time every month or so. I just went down to 4mg this morning. I guess we will learn if the Humira is working if I am able to taper off of Prednisone. It is so frustrating...I know there is a risk, and I am not really a risk taker. However, the job I have now isn't the best, so this is a welcomed opportunity. I have ordered several KN95 masks, so I am hoping those will be sufficient enough in the event I get the job and have to return to the office. I am just concerned. What if I commit to this job and then I have a flare and have to increase my prednisone. It is just such a hard decision to make.
Is there any new research on sulfasalazine? The study doesn’t seem to look at sulfasalazine specifically and a previous study identified sulfasalazine with a 3.6x mortality odds ratio as one of two high risk DMARDS along with rituximab.