Are biologics only for RA? Not Osteoporosis?

[Wyaatch]

The RA doc just said my X-rays show cartilage loss on both hips--and since MTX didn't work I was thinking he might think of starting biologics but he said well, biologics won't do any good now. When I asked what could be done next--he didn't address pain which I've been asking about the past 3-4 visits--but said maybe an orthopedic surgeon can help--Anyone know if biologics dont help osteoporosis? Only RA? I guess I don't understand why they started me on MTX----if he thought the X-ray showed osteo was the problem. Anyone? Thx.

[Lucy11]

Hiya,

First, do you mean Osteoarthritis not Osteoporosis? Either way, Biologics are intended to help inflammatory autoimmune diseases, RA being one of them not OA or Osteoporosis.

Do you have an RA diagnosis? If so, this would be the reason for MTX.

However, it's not uncommon to have both RA and OA (Osteoarthritis)

If it’s your hips that are bothering you and he suggests and Orthopedic surgeon then you may be a candidate for a hip replacement. If you had imaging done they can tell the difference between OA and RA.

In the mean time did you ask what to do about the pain? There are lots of people on this site that have ideas and recommendations to help with the pain and I imagine if its bone on bone it's pretty painful.... Sorry I can’t help you with that.

I wish you the best.

Lucy.

[helixhelix]

Once damage is done, then it's done. It's only in unusual cases (like Lucy who replied to you) that erosions can heal naturally. And cartilage is more unlikely still. Biologics won't make any difference to existing damage, or to osteoarthritis.

The most common reason for damage to hips is osteoarthritis, and often leads to hip replacement surgery. There is a women in my Pilates class who has had both her hips replaced and she says no pain anymore and she has full movement back. As well as Pilates she does weekly 12km walks, and is very bendy. But if the pain is elsewhere then you can ask to be sent to a pain clinic.

Have you been diagnosed with RA? Presumably that was why you were started on MTX. What has your doc suggested to replace it if you have stopped? And is the RA causing problems with other joints? As biologics are usually only given to people with active disease. But there are many other drugs for RA apart from MTX and biologics.

[ITYFIALMCTT]

Biologics are sometimes prescribed for erosive osteoarthritis - but that tends to present strongly in the hands and feet (tho' can sometimes occur elsewhere and erosive osteoarthritis is a differential diagnosis for psoriatic arthritis).

As Lucy says, it's not unknown to have both an inflammatory arthritis and osteoarthritis.

However, to some extent, if the cartilage has deteriorated beyond a certain level then an orthopaedic referral with a view to future surgery sounds appropriate.