Monday, November 12, 2012

Tofacitinib

There is a new drug for the treatment of moderate to severe RA.  Tofacitinib was approved by the FDA this past week ahead of schedule.  Tofacitinib provides a new treatment option for the debilitating disease of RA who have had a poor response to methotrexate, Badrul Chowdhury, MD, PhD, director of the Division of Pulmonary, Allergy, and Rheumatology Products in the FDA's Center for Drug Evaluation and Research, said in a statement.  The most common adverse reactions in clinical trials were upper respiratory tract infections, headache, diarrhea, and inflammation of the nasal passage and the upper part of the pharynx.  In clinical trials, tofacitinib was associated with an increased risk for serious infections, including opportunistic infections, tuberculosis, cancers, and lymphoma. The drug carries a boxed warning regarding these safety risks, the FDA said.  The drug is also associated with increases in cholesterol and liver enzyme test results and decreases in blood counts.  I am currently doing well with the MTX and Humira combo but I sincerely hope this helps those who have trouble with or simply can not take methotrexate.

I have been hammering out miles on my bike over the past 4 weeks taking advantage of our gorgeous fall weather.  I have put in 1100 miles, not including today and tomorrows rides.  We had a cold front push through yesterday morning.  My last night to work last week was Saturday night and I got off at 7am yesterday morning.  The temp at 7am was 74 and although I was tired, I came home after working a 12 hour shift and put on my gear and headed out for a quick ride before the cold weather moved in.  It felt great but the 30-40 mph winds were whipping me like a rented mule.  It can be a little unnerving to come into a turn at 60 mph just as a wind gust pushes you over a couple of feet while leaning the bike through the turn.  I only put in 45 miles before the lightening and rain moved in, but it was a nice relaxing ride with almost no traffic out early Sunday morning.

On a ride last week, I was headed out to the west and had been wanting to visit the Skullyville County Jail, so I loaded the coordinates in my gps and headed out.  I was amazed that it is in as good shape still as it is.  The jail was added to the National Historic Register in April, 1980.  It replaced the original jail in 1888 (original jail was built in the 1850's) at the same location and the walls are rock, 2 feet thick.  It has one door, heavy iron bar, and one tiny window with iron bars.  While I was stopped there, an older gentleman stopped to see if I needed help and I told him I was just taking some photos of the old jail.  He told me that he wished they would open it up so you could actually get inside ... "there's a lot of history in there", he said.  He told me one of the stories passed down was that Jesse James had been held overnight by Pinkerton agents in the original jail here.  Not attempting to glamorize Jesse by any means, but it was kind of cool thinking you were walking around where Jesse did in years gone by.

5 comments:

Wren said...

Wow, what a tiny window--no larger than the individual cut stones that form the jail themselves. Makes me shudder to imagine being locked up in there, even just overnight like the infamous Mr James.

Glad to read that you're feeling decent and that you've gotten so much good riding in during the last month or so, Terry. And glad, too, that autumn has been so nice for you this year. The last week has been absolutely beautiful here, autumn-leaves-wise, and we even had a couple of chilly, showery days--the first days under 65 degrees we've had since April. I'm looking forward to a few more of those--and more rain, too. In that, I know I'm not alone, with so much of the midwest and west locked in this awful drought.
Here's hoping that you get to take several more terrific rides before winter shuts things down for you for a while. I hope,too, that you'll feel good and have very little pain as the season progresses. Wishing you the best, as always, m'friend.

OH-- I have to say, it's great that they've come up with a new drug that promises to be as effective as MTX for those who can't take the older drug. But dang, it sure is horrifically expensive. Makes me wonder how many people will actually get to take it, considering how stingy the health insurance industry tends to be. Fingers are crossed, though.

abcsofra said...

I truly hope that those that need it can access it and that it is their miracle for them. It is out for me with possible cancer side effects. As you know I have already had two cancers and dare not temp that fate! The weather here has been oh sooo beautiful but along with it comes the stupidity on my part to overdo. Oh well, it was all for a good cause in the end. I am so looking forward to more of those beautiful pics. That building reminds me of how I feel on days when I want to pull in and be by myself. Four walls, little light to get in, and lots of concrete to keep out others :-) Keep on keeping on!

Terry said...

Wren, I couldn't get over the window either. I have been doing so good until the front moved through yesterday. I have hurt so bad today that it caused me to cancel my ride. We need rain here very badly. I was going to say something about the outrageous cost and got side tracked, thank you for bringing that up!

Deb, wouldn't it be great if they could come up with a new med with little to no side effects? I know ... it'll never happen. I can understand your position. I am not going to pursue as long as MTX continues to work for me. It wasn't stupidity, we all tend to overdo it when the weather is nice and we feel good ... we have to even though we know the consequences.

Anonymous said...

Old jail is cool! Good to hear you have been putting in the miles, respectable mileage for someone healthy. Keep on riding.

Terry said...

Thanks anon, the old jail was pretty cool. I have several things bookmarked and try to ride to them when I am on my own and riding a more leisurely pace.