Emily Iseman Intern Mentor Program Mount Hebron High School Arthritis Care Specialists of Maryland Mentor: Kathleen Skolnik
Upcoming Information Rheumatoid Arthritis Treatment Options Biologic Drugs Arthritis Care Specialists of Maryland Surveying the Patients Conclusions Drawn
Rheumatoid Arthritis Autoimmune Pain, swelling, stiffness Medications: Oral Subdermal Injections Intravenous ACR 20 20% decrease in swelling 20% decrease in pain & disability
Methotrexate Liver toxicity Immune suppressant Disease Modifying Antirheumatic Drug
Biologic Drugs Attack the immune system Animal proteins
Remicade TNF-inhibitor (TNF attacks healthy tissue) 1 st line of infusions used
Orencia T cell inhibitor (reduces inflammation, swelling & pain) 2 nd line of infusions used
Actemra Blocks interleukin 6 (reduces inflammation 3 rd line of infusions used
Arthritis Care Specialists of Maryland Mentor: Kathleen Skolnik Priming IV Tubing Setting up Trays Monitoring Patient Vitals Developing Relationships with Patients
Surveying Patients Gender Age Current Biologic Past Biologics Methotrexate? Pain and Mobility HAQ 20-item Disability Scale
Results - Remicade Remicade and Methotrexate (18) Average HAQ-.885 HAQ = 0 – 3 Pain improved w/ MTX? - 3 Mobility Improved w/ MTX? - 10 Remicade (12) Average HAQ-.139 HAQ = 0 – 4 Pain improved w/ MTX? - 0 Mobility Improved w/ MTX? - 0
Results - Orencia Orencia and Methotrexate (4) Average HAQ-.25 HAQ = 0 – 1 Pain improved w/ MTX? - 1 Mobility Improved w/ MTX? - 2 Orencia (1) Average HAQ- n/a HAQ = 0 – n/a Pain improved w/ MTX? – no difference Mobility Improved w/ MTX? – no difference
Results - Actemra Actemra and Methotrexate (3) Average HAQ HAQ = 0 – 1 Pain improved w/ MTX? - 0 Mobility Improved w/ MTX? - 0 Actemra (2) Average HAQ HAQ = 0 – 0 Pain improved w/ MTX? – no difference (2) Mobility Improved w/ MTX? – no difference (2)
What am I doing with this? Pamphlet! Presenting Pamphlet to doctors/nurses at my internship
Conclusion Methotrexate does not need to be paired with Remicade or Actemra (no difference or better feelings and HAQ), and there was not enough information collected to determine the difference with Orencia
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