dupixent injection !does it help in gca ?

[Rajuguide]

My wife is suffering from gca type symptom , from last 15 months , ( biopsy could not be done ) treatment started,tapering from 60 mg with only 4 months actemra  taken due to side effect ,now she is struggling to reduce prednisone from 10 mg to 9 mg ,from last 5 months with flare up -down she tried Methotrexate but stop due to side effect , Now doctor from last 3 months started ,injection DUPIXENT biweekly,   ,does any one have any idea or  experience of it , does it give relief or benefit in gca , or reducing steriod dose .I am sorry my wife have no benefit effect till date . I confused shall she continue with it , as dr advice . ?

And  secondly, Is it safe to be on 10 mg continuously for more long period , if no other choice? I thanks for previous advices received in this forum, which  help me to lot .🙏

[PMRpro Ambassador]

"Dupilumab, sold under the brand name Dupixent, is a monoclonal antibody blocking interleukin 4 and interleukin 13."

Neither interleukin 4 nor 13 have traditionally been associated with the inflammation in GCA. However, there are mentions in the literature of both in association with GCA patients though as far as I could see there have been no definitive studies.

However - I think you need to get out of your mindset of associating your wife's GCA-type symptoms with being GCA as we discuss it. You told us some months ago that they had done cytokine studies and found that her IL-13 level is high. They are now using a monoclonal antibody treatment which is specific for IL-13 and as such that should reduce the levels. You will have to wait and see if it does.

I have been on pred at well above 10mg/day for the last 3 years and most of the 13 years I have been n pred I have been at 10mg/day or above. It doesn't appear to have done me much harm. There are a few others on the forum who have needed doses of 10mg and above for considerable periods. If there is no other option - you have to accept it. It hasn't killed us yet.

[Rajuguide in reply to PMRpro]

I had no words to thanks you , I appreciate your deep knowledge in gca realated problem ; And you always guided and advice me , this time also you have clear my doubts, which was confusing me from last so many days

Many, many thanks

Rajuguide

[jls93 in reply to Rajuguide]

I had used methotrexate on a few occasions in an attempt to help me wean prednisone. I tried pills on 2 separate occasions and self injections on a third. The injection trial was to mitigate side effects the worst of which for me was a copper (like) metallic taste on my tongue, fatigue and a nausea . During this time frame 3 years +, I underwent a few orthopedic surgeries . For me and my PMR, it did not help me taper prednisone effectively but I did give the methotrexate a legitimate try ( pills and injections). Currently I am using injections of TNF inhibitor (tumor necrotic factor inhibitor) which had been effective with allowing prednisone taper. Hope this helps.. Sincere Blessing to you all!

[Rajuguide]

thanks for sharing your experience with me , I will talk dr about TNF .

I wish for your good health.

thanks

[PMRpro Ambassador in reply to Rajuguide]

It is only of any use in situations where tumour necrosis factor is involved. They did look at the cytokines - they do have some guide as to which inflammatory substances to attack.

[Sweetpants]

Yes, Methotrexate does have some side effects, like nausea, loss of appetite, loss of sleep etc. So if experienced such, better to stop taking and ask for other options..