Some folk here may be familiar with my condition after reading my recent "Desperation boulavard" post, for those who aren't, here's a brief rundown....
I stopped taking all my RA immune suppressing meds back last March. The reason being that I get recurring UTIs, one of which led to me getting septic arthritis in my hip, aka - sepsis at that time...not a very pleasent experience!! I was on enbrel and MTX at the time and my orthopedic consultant said he thought enbrel played a significant part in allowing a UTI bug to get into my bloodstream and causing the sepsis, so advised me not to take it again. Not much said about MTX but I decided to stop taking that as well to cut down on the real risk of me getting sepsis again.
Anyway, as my RA has become seriously painful and debilitating - I can barely walk and am nigh on housebound, I decided that I need to go back on an immune suppressor of some kind, if only to give me at least some relief from this awful disease. My rheumatologist) was very concerned when she saw the state of me as I have deteriorated quite a bit since she last saw me 4 months ago. She suggested that I go on a low dose, 10mg, of MTX and also wants me to start injecting abatacept as my RA is so severe that she doesn't think MTX will help much on its own. I'm already on hydroxy by the way, which seems to be doing next to nothing for me. Obviously I am very reluctant to go on another biologic drug after the enbrel/sepsis episode, but my rheumatologist said they are finding that abatacept has less of a negative affect with infections than other RA meds, which swayed me towards giving it a go, so I agreed to start taking it. However, I'm now having second thoughts. I was asked to phone the rheumy secretary tomorrow to see if my chest x-ray and blood tests are ok so I can start the meds, but had a phone call this morning to make an appointment with the rheumy nurses for next tuesday - seems like they want to get the ball rolling quickly on the abatacept front, presumably showing me how to inject etc. I did tell them that I'm having second thoughts and did not want to waste their time getting things going as I may well decide not to go ahead with it, but they still want to see me in any case if only to talk about my concerns.
So, decision time is fast approaching - to inject, or not to inject, that is the question? If I decide not to start abatacept because of the sepsis risk - antibiotic bug resistance also enters the equation, which at the minute I don't think I will be, even though it could mean a significant improvement with my RA and quality of life, which at the mo is pretty grim. Or just stick with mtx and maybe ask rheumy what they think about increasing the dose from 10 to say 20mg and take it from there. Of course MTX can take some time to start working, so that will mean a fair old wait and a lot more pain, to see how well it works for me, but I'm willing to put up with that.
I would appreciate any thoughts as to what other folk would do in my situation? Even better, is there anyone on abatacept who also suffers with recurring infections?