CLL & Biologics for Arthritis

[garrick66]

I am curious if there is anyone in the CLL community who is using a biologic for their rheumatoid or Psoriatic arthritis ? I am on W&W and am dealing with some pretty serious arthritic pain in my knees. I am 11q del with nodes continuing to grow so treatment is around the corner sooner than later I suspect. There are lots of ways to treat arthritis but most seem to be with biologics like Humira, Enbrel, or Otezla and others, or even Methotrexate. All of these drugs suppress the immune system which is already compromised from CLL. Are these drugs Ok to take with Ibrutinib or Acalabrutinib ? Are these drugs just opening you up to infections or other cancers ? is the alternative that you just live with the pain.

[Emcee1]

Have to consult with oncology

[cllady01 Former Volunteer]

Read "Are you taking too many inflammatory Drugs ( posted by CLLCanada today about 4 hours ago. Then read the link he gave (below, here)

health.harvard.edu/blog/are...

[pkpayne]

Garrick I can't answer your question about Biologics for arthritis medications but they are who I get my Ibrutinib from. I am also 11q and unmutated and I am worried about another issue I have that is also known to affect the immune system although I haven't been treated for it as yet. That will be next.

[Cllcanada Top Poster CURE Hero]

Rituxan is used to treat both for CLL and RA... two birds, one mab...

[mariemascio]

I've run into a couple of people on this site who have used biologics for their psoriasis and then later developed lymphoma. I've heard that that the systemic psoriasis drugs suppress the cancer finding/fighting function of our t-cells (tumor necrosis factor or TNF) and that may be one reason these drugs are associated with higher risk of cancers.

But your question seems like a good one for the oncologist prescribing ibrutinib. Dunno if my info is helpful at all. Take care. - Marie

[nonna]

i'm on a natural kick right now. I seriously feel my arthritis is easier to deal with when I am gluten free, dairy free, sugar free and alcohol free. i know this is really simplistic but it keeps me in drug free.

[Tommays56]

Hi Ga

My wife does not have CLL but has been on all 3 biologic with Methotrexate and its complex as while there is the pain she would have permanent damage/disfigurement in many joints especially the hands which just cant be left untreated

While every case is different i have to assume if you require these meds you have reached a pretty serious point and the Doctors involved need to work together to find the best comprise BUT its quite difficult to get on any of the biologics due to the high cost and there generally the last resort

[tmijohnson]

My husband has CLL and is in W&W, but I take biologics for ulcerative colitis (Remicade). I would be very nervous about the anti-TNFa (tumor necrosis factor alpha) drugs, given that lymphomas are one of the potential serious adverse affects.

However - there are drugs for autoimmune diseases that work by different mechanisms. For example, we have gut-specific biologics for UC and Crohn’s that do not impact TNFa. You may have comparable options for PA.

For sure talk with your rheumatologist and CLL specialist - and importantly, try to get them to talk to each other. Good luck!

[Rose_fancier]

I suffer from inflammatory arthritis that has not been confirmed to be either Rheumatoid or Psoriatic arthritis. I tried Humira for a short time before being diagnosed with CLL. At that point the Humira was stopped and I went back to the combination of Methotrexate and Sulfasalazine I had used before trying Humira.

Since then I have had joint replacements in both knees which took care of most of my pain from my osteoarthritis, but I still have joints in my hands, right shoulder and other areas that swell and cause pain.

I am in watch and wait and am being monitored by Dr. Jeff Sharman. I asked him for advice on what to take to control my arthritis. He advised me not to try Humira again but to stay on the Methotrexate/Sulfasalazine combination if it was working for me. His reasoning was that it is a known fact that Humira can cause lymphoma, but there has been no research conducted on how Humira affects CLL progression. Dr. Sharman felt that the doses of Methotrexate and Sulfasalazine I was taking wouldn’t affect my CLL. He did say that if the Methotrexate/Sulfasalazine combination stopped working, Rituxamab could be tried.

While this seems to be working for me so far, I urge you to consult with your oncologist and rheumatologist for treatment options for your specific type of arthritis and CLL.

[garrick66]

I see DR Sharman also, as I live up in Beaverton so he's not too far. I remember he told me that Ibrutinib and Acalabrutinib were once being tested for arthritis treatment and once i start tx they may help. Thanks for the advice, I hope you stay in WW for a long time.