Kevzara and Hepatitis B vaccine

[msdale]

Hi all - I realize Kevzara is used in US, so if anyone in the US can chime in, would be appreciated.

I have decided to try Kevzara after six years on prednisone and at 7 mg right now.

Was anyone out there prescribed Kevzara without first getting a Hepatitis B vaccination? I'm told by pharmacist working with my doctor that I can get the vaccine later, although there is a chance it would make the vaccine less effective.

If I delay starting the Kezvara in order to first get the Hep B vaccine, it will add at least two months to when I can start, which could be a problem next year given that I might not be able to afford Kezvara in 2026.

So just wondering what advice anyone else has gotten from their doctors in this regard.

Thanks for any input.

- Mary

[Grammy80]

Hi , I'm not sure if this will help much but....

I've had GCA for over five years and have been on Actemra, tocilizumab, and steroids. My case has been and continues to be VERY stubborn. I went to the rheumy today; I've been on 10mg per day 6-7 weeks, now I start reducing by 1mg every two weeks until I get to 5 mg and I will stay on five for the duration of my time on earth, I'm 84.5 years old. I'll also remain on the Actemra.

Recently, I was put on Ozempic for diabetes and have had no problem

I had no side effects or problems with any of the vaccines or the medication itself. I've been told that there is a possibility that some will be less effective...but so far, so good. I think the fact that a certain vaccine may not be as effective may result from my immune system, too.

I'm in the US and believe in trying something that might help; you can always stop. Hopefully, Kevzara helps you....my best to you.💞

[msdale in reply to Grammy80]

Hi. Yes, that is helpful (and encouraging!) and I appreciate your reply. I'm having a video meeting with my practitioner (doctor or Nurse Practitioner) on Friday to go over everything again.

Before taking Kevzara, one is supposed to have several tests - liver, lipids, etc. This somehow got overlooked until I pointed it out..... sigh. So one really does have to advocate for one's self.

I'll decide on the Hepatitis B vaccine after I speak to the doctor again.

Anyway, thank you for sharing your experience.

[PMRpro Ambassador in reply to msdale]

I had all the tests before Actemra and get them every 3 months, see the rheumy every 6 months. But I didn't have any vaccinations before starting the injections 3 years ago. I have Covid and flu jabs as they come and just had shingles and pneumonia a few weeks ago. Nothing else was mentioned and it would be strange for my guy to forget.

[msdale in reply to PMRpro]

Thank you. That's very useful information that you didn't get other vaccines before starting the Actemra. I am speaking with rheumatology practitioner in just a few days via video, so hopefully I can sort all of this out. I may be making a big deal out of what really doesn't need to be....

[SnazzyD]

Do you mean a booster? If it is your first time you need a course of three and there are different protocols for gaps in between doses. It isn’t a live vaccine and yes any immunosuppressant can potentially have an effect on the immune response to any vaccine. Unless there is a particular risk of Hep B for you, I’m not sure of the value of delaying the Kevzara, so I would ask.

[msdale in reply to SnazzyD]

Oops - see below - I mean to make the paragraph below as a reply to you.

[msdale]

Hi - thank you. Appreciate your input. No, not a booster. Apparently, the vaccines were given routinely after 1982 or something like that, and therefore I wouldn't have gotten the original vaccine as a kid. No great risk other than using the pen to inject the Kevzara, but I tend to agree it would really slow down getting the Kezvara. I just read about a newer Hep B vaccine which is only two shots, with two weeks in between but it's an uphill battle right now to get all of that approved by Medicare. Soooooooo.... leaning towards just getting started on the Kezvara, depending on my test results. It was just unnerving to have to be the person to say, 'Umm, excuse me, but the literature here says I need these tests before I even start.... hello??' But thankful I caught that.

[SnazzyD in reply to msdale]

If you are using disposable needles/pen from an unopened pack, you should have no risk of HepB. Unless things have changed with HepB vaccines the quicker dose plans were potentially less likely to give a long lasting seroconversion. Things may have moved on but it’s worth asking.

[msdale in reply to SnazzyD]

Thanks - will be using disposable pens. That is good info re the quicker dose Hep B plans. Will ask doctor on Friday but I'm leaning towards just going ahead and not delaying - I'm kind of a scaredy cat when it comes to drugs. Got blood tests today and we'll see how those come out.

[msdale]

Just a note - I am so, so thankful I found this group. So much support, information, and encouragement. Thank you to everyone!