do I have indication of immunosuppresion?: I work in... - NRAS

NRAS

36,428 members45,077 posts

do I have indication of immunosuppresion?

simba91 profile image
10 Replies

I work in the nhs and have to do a self risk assessment.

Am.i classed as having any indication of immunosuppression???

I have rheumatoid arthritis. I am on sulphasalazine, folic acid, hydroxychloriquine. I recently changed from methotrexate to sulfasalazine.

Written by
simba91 profile image
simba91
To view profiles and participate in discussions please or .
Read more about...
10 Replies
Karen12 profile image
Karen12

I too work for the NHS and had to do a risk assessment. My understanding is that Sulphasalazine and Hydroxychloroquine do not count as immunosuppressants according to the Rheumatology Society. Our OH department actually gave a list of medications that they consider may cause some immunosuppression Methotrexate and Prednisolone were mentioned.

The BRS state the following...

Immunosuppressant medication:

Azathioprine

Leflunomide

Methotrexate (S/C injection or oral)

Mycophenolate (mycophenolate mofetil or mycophenolic acid

Ciclosporin

Tacrolimus

Sirolimus

This DOES NOT include hydroxychloroquine or Sulfaslalazine, either in combination or alone

So I’d take that to mean you are not immunosuppressed.

KMC15 profile image
KMC15 in reply to

Is retuximab on the immunosuppressant list?

in reply to KMC15

Falls under the separate Jak inhibitor/Biologics heading. When they were using a scoring system to help people identify if they should shield, SSZ and hydroxy either separately or in combination scored a 0. A single immunosuppressant, Jak or biologic scored a 1. Two immunosuppressants, or one and a Jak or a biologic being taken at the same time scored you a 2. Pred use at 20mg or above for 4 weeks or more was an instant 3: there were a few other criteria to score, but if you got 3 in total, you should shield. Rightly or wrongly, I take the higher score numbers with meds to indicate the degree of immunosuppression you’re deemed to have.

KMC15 profile image
KMC15 in reply to

Soz I'm very confused.... I had my 2 lots (1 treatment of retuxi end march/beg apr) & have inhalers so how would you interpret my score?

in reply to KMC15

Purely for the arthritis meds? A one, because you’re taking a single biologic. But then you also have to look at whether you have any comorbidities and that kind of thing. The chart has disappeared from a lot of places, but some individual NHS trusts are still using it to help patients:

wsh.nhs.uk/Services-A-Z/Rhe...

KMC15 profile image
KMC15 in reply to

Thank you Charlie_G I received a similar chart when I had my infusion & the ward sister & nurse, then rhumy nurse agreed I was 1 (possibly 2 with asthma meds) but defo not shield. BUT I did only go out for a very short walk down street when quiet during lockdown. I received a high risk letter (on my birthday 28 may) which was the one needed for employer as not to work other than from home and that's till 30th june minimum. So again only been out 1/2 week for short walk WHEN CAN due to pain, to try help stiffness. The thought of another 6-7wks !!!, but rather be safe. X

KMC15 profile image
KMC15 in reply to KMC15

So that's me received my letter until 1 aug (can meet up to 6 people outside from 6 july) but 5 weeks till can go shops etc while general public can go about as tho nowt happening - like a lot are now anyway. But at least we may be safer. It's just such a LONG time. Which is not helping my mental health & my r.a. is suffering so much. Even if I wanted to go out 4 exercise my joints wouldn't let me!

AgedCrone profile image
AgedCrone

If you have stopped taking Mtx...check with your rheumy nurse that you should still be taking the Folic Acid.

It is not normally prescribed with SSZ & Hydroxy.

Tompark profile image
Tompark

No not with these two. I also am in nhs and I take sulfasalazine but I do keep strict social distancing and avoid busy areas and always wear masks

You may also like...

Do I have a disability or not

week that I don’t have a disability because I can walk. I explained to them that I do have a hidden...

Do I have to return to Work?

wisdom has said that we have to re-open and return to work. I am very anxious as I have barely been...

Do I have my 2nd MTX injection or not?

don’t know what to do. Who could I call to find out. Any help appreciated.

Do I have RA

Hi all, I have a Dr appt tomorrow, but just wanted to know some obvious symptoms. I have had...

Do I have RA?

minor head wound have been diagnosed with RA and have been put on Methotrexate and Folic Acid...