I Have Rheumatoid Arthritis And Have Heard About Cimzia... What Is It?

Biologic therapy has revolutionized our approach to the treatment of rheumatoid arthritis (RA). Less than 10 years ago, the best we could hope for was to modify disease or slow it down and also help with symptoms. Now the goal is to not only control symptoms, it is to get RA into complete remission. Biologics are protein-based medicines that are synthesized in a laboratory. They act like laser beams to target the immune abnormalities that are felt to cause RA.

First generation biologics such as etanercept (Enbrel), infliximab (Remicade), and adalimumab (Humira) are known as TNF-inhibitors and have done wonders for many patients. Second generation biologic such as rituximab (Rituxan) which acts against B cells and abatacept (Orencia) which works on T cells are both welcome additions to the arsenal of weapons available to combat RA.

Cimzia (certolizumab) is an investigational TNF-inhibitor. It differs from the current crop of TNF-inhibitors since it is pegylated. This means that a substance called polyethylene glycol has been attached to the molecule. This pegylation lengthens the half-life of the drug- meaning the drug stays in the system longer. Cimzia also has had a piece of protein removed from the molecule. The piece of protein that has been removed contained a small amount of mouse protein (yes... these drugs are often created using mouse proteins). By removing the piece of mouse protein, it is hoped that Cimzia will cause fewer adverse reactions.

A recent presentation on June 14, 2007 at the annual meeting of the European Congress of Rheumatology (EULAR) described data on Cimzia.

The team studied 2 dose regimens, which patients received subcutaneously as add-on therapy to methotrexate.

In a phase 3, multicenter, double-blind, placebo-controlled, parallel-group study, the investigators recruited 992 patients with RA who received either the study drug or placebo. The investigators wanted to know the rate at which people had a 20% improvement, as defined by the American College of Rheumatology criteria (ACR 20).

The patients, who had previously been treated for at least 6 months with methotrexate, were randomized to treatment with either pegylated certolizumab or placebo. Those on treatment received 3 400-mg doses every 2 weeks, followed by 200 or 400 mg doses of certolizumab pegol every 2 weeks. The patients continued methotrexate as usual. The investigators assessed the efficacy and safety parameters at 2-week intervals.

In an early analysis at 24 weeks, the investigators found that 581 patients completed the study: 259 of the 397 on 200 mg of the drug, 278 of the 394 on 400 mg, and 44 of the 201 on placebo. The ACR20 response rate was 59.2% in the 200 mg group, 61.2% in the 400 mg group, and 13.5% of those who received methotrexate and placebo. The proportion of patients who experienced a significant side effect was 74.0% in the 200 mg group, 76.1% in the 400 mg group, and 57.7% in the placebo group. The majority of adverse events were mild to moderate.

"Pegylated certolizumab adds significant benefit in reducing the signs and symptoms of RA in combination with methotrexate, compared to using methotrexate alone," said lead investigator Edward C. Keystone, MD, professor of medicine at the University in Toronto, and director of the Rebecca MacDonald Centre for Arthritis and Autoimmune Disease, in Ontario.

Bottom line: Pegylated certolizumab works like a TNF blocker and appears to treat the signs and symptoms of RA. Whether its better than the TNF blockers that are currently available is still no known. It is better than placebo.

Nathan Wei MD FACP FACR is a rheumatologist and Director of the Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine. For more info: arthritis-treatment-and-relief/arthritis-treatment.html Arthritis TreatmentBipolar Spectrum Disorders
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Choosing Your Cancer Caregiver & Tips for Cancer Caregivers

Battling Cancer is an individual journey that takes all of heaven and earth to combat.

Choose your caregivers well!!:

Your Caregiver walks a fine line between reality, support cheerleader, hand holder, master "hugger" and "inspiration machine", and friend, who must give that medicine, drives you to treatment, and fusses at you to keep you on track for your healing journey.

Your Cancer caregiver is your primary filter and monitor of your visitors, both family and friends. They should only allow POSITIVE PEOPLE!!! and ONLY people who are emotionally nourishing for you.

YOUR LIFE DEPENDS ON IT!

They should encourage you to be surrounded by individuals who treat as if you are living and expect you to have a future. No "what if'ers,' no "maybe that won't work", or "oh you poor dear", or any others who say negative things.

If ANYONE ever says to you "before you were living with cancer, now you're dying with cancer."

Remove them from your life until they can be respectful and empathetic! Not only are they unable to determine your death, they are also unkind to make a remark like this.

If they say to you, "I was just making a realistic statement so you won't be in denial and we can address your will, funeral plans, and future provisions." FORGET THAT justification!!!!! NO ONE who truly cares about your heart and soul, would ever say anything like that.

Do not be so needy for attention, that you allow yourself to be the "victim" of comments that are TOTALLY inappropriate!! no matter how sick you are. As long as there is breath in your body, you have the right to be treated with respect and dignity, and as if you are going to live!!!

Family members as Caregivers:

If you have spent your life helping others, and enabling them, it's time to stop that energy drain. This does NOT mean that you do not love them anymore. It means that you care enough about yourself to take care of you FIRST, so that you can be around in the future to help them.

Non-healing: 1. "But he's my brother and he just drinks a little too much, and he wants to come visit"..... His energy will drain you!!! Visit with him when you are healed!

2. At this time, YOU do NOT need to hear their problems. They need to support you!

Friends as Caregivers:

There are several kinds of friends during this time in your life.

The talkers:

They call to see how you are, listen for a short period of time and then spend hours telling you about their life. They ask if they can do anything for you. When you mention that you need a ride to chemo on Thursdays, their answer is, "I'd love to take you, but I have book club." Do not be discouraged. This person is interested enough to call, but NOT authentic about truly helping you or they would have taken you to chemo.. There will be more book clubs, this is your battle with a disease! Thank them for calling, and get off the phone.

You are not THAT needy to have to talk with someone who won't really be there for you!

The Doers:

These are the friends that pick you up, sit through, and bring you home after chemo, and probably add fresh flowers to your home. Be thankful. They encourage you to live with every dinner invitation, movie, or "let's go to" invitation. GO! Do not feel like you are "putting them out", "being a bother", or whatever. When you are well, YOU can DO for them!!!!! They are your Earth Angels.

Being the Caregiver for someone battling cancer, and going through cancer treatment is a job that requires everything you can muster to handle your work and all of your coping skills.

Advice for the Caregiver:

1. Treat your Cancer client as if they are going to live. DO NOT treat them as if it's just a matter of time. Always speak of their "experience" NEVER a disease.

2. You will most likely be caught up in the overwhelming environment of caregiving, and handling every life and medical detail and decision.

Try to look at the patient and all of their circumstances as if they are in a healing situation, and in a positive manner. Don't be a Pollyanna, but try to put a positive spin on everything that you can.

3. Although your patient has "determination to live", that determination needs to be rooted in positive. Positive energy raises their body's physical energy frequency which fights their disease.

4. Creating a positive uplifting environment:

a. Dress in happy colors.

b. Help create a environmentally pleasant and visually happy care area. Little touches mean a lot!

c. Only allow positive people around your patient. EXPLAIN why the negative folks need to stay away, and help keep them away.

d. Be very conscious of how YOUR energy can effect the "patient."

If you view the patient in a "sick" condition, you are sending negative energy their way!

If you have a negative attitude, or irritable responses, you generate negative energy which lowers your patient's physical body frequency and DOES NOT help heal the disease. Your energy field will affect your patient.

e. Keep your energy field clean. Your patient is like a sponge and absorbs and interacts with all the energy surrounding them and that they are exposed to.

5. Contributing Life force energy thru Love:

On numerous occasions, family and friends have asked how they can contribute positive energy to the "patient." [An educational note: The hand that you write with is your energy sending hand. The other hand is your energy input receiving hand.] So follow the directions below according to whether you are right or left handed.

Take your left receiving hand and place it on your heart, and take your right sending hand to hold the patient's left hand (receiving hand). Then say to the patient, "I send you the love from my Heart and it's healing life force energy to use as you so choose."

You then become an "energizer" bunny for the patient thru your love for them.

You are invited to download our free pamphlet with excerpts from this book

"Positive Attitudes, Affirmations & Actions to Help Survive Your Cancer Experience" ISBN#: 978-0-9766370-0-4.

at brentatwater/

or brentenergywork/BOOKS.htm

Feel free to reprint this article in it's original format with the disclaimer.

CONTACT INFORMATION:
Brent Atwater, Alternative Medical Specialist
Atlanta, GA 1.404.242.9022 USA
NC Office: 1.910.692.5206 USA
: BrentBrentAtwater

Disclaimer: There are no guarantees about the healing properties of these suggestions. We can only state that positive results have been documented for individual clients and research in this area continues. Ms Atwater is not a medical doctor or associated with any branch of medicine. Ms Atwater works in Alternative, Integrative and Complementary Medicine. She offers her opinions based on her intuition, which is not a substitute for medical procedures or treatments. Always consult a physician or health care provider concerning any medical problem or condition before undertaking any diet, health related or lifestyle change program.

There are no guarantees with any of the suggestions in this publication.

Brent Atwater: Medical Intuitive, Energy Healing: As an alternative medical specialist (CAM), her international evidence based Medical Intuitive & Distance Energy Healing work is published and has been studied by & or documented at Duke, the ARE, & for animals by the NCSU's Vet school. She participates in research & Clinical trials. ARTIST: An artist 30+yrs, Brent is a pioneer in healing art by scientifically documenting Paintings that Heal. Her art was featured on "PBS". At 16, NC Museum of Art chose her painting for the permanent collection. She founded Just Plain Love Charitable Trust to benefit children. AUTHOR: Just Plain Love Children's Healing Books. The books are translated into plays performed in children's healthcare facilities turning illness negatives into positives. "Cancer Kids, God's Special Children". "Positive Attitudes, Affirmations, & Actions for Overcoming Your Health Challenges", & "Positive Attitudes, Affirmations & Actions to Help Survive Your Cancer Experience". Brent attended Wake Forest Law School and is a minister.Lamictal Dosage Bipolar
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