Rheumy doesn’t think Plaquenil works. - Scleroderma & Ray...

Scleroderma & Raynaud's UK (SRUK)

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Rheumy doesn’t think Plaquenil works.

Bee1011 profile image
14 Replies

I am diagnosed with UCTD suspected to be Crest and Sjögrens, I am at a combined chest clinic in April as I have lung involvement consistent with minor lung disease. I have hiatus hernia am on lansoprazole and co-codamol 15mg/500mg for pain and muscle ache (my gp gave me that not rheumy!) but it doesn’t really help much. I also use hylo fresh for my dry eye. I have raynauds, extreme fatigue and esophagus involvement though this part is only minor at present.

I also suffer with IBS.

My question is last time I saw my rheumy I asked about Plaquenil and he wasn’t keen to try me on it as he said he isn’t a big believer in it working. If he felt like I do everyday he might be willing to try it !!! I feel like I’m recovering from the flu most days, it’s not good. If I try to fight through it I just end up sweating and feeling faint and poorly so I have to give in to it and lie down.

What are everyone’s feelings on Plaquenil ? Surely I can’t be expected to just carry on like this with no treatment !!

Rheumy hasn’t prescribed any treatment.

Lansoprazole was given by gp a few years ago for heartburn, I now know why.

Hylo fresh from optician for severe dry eye, again it’s all now tying together(Sjögrens)

Painkillers from gp as I couldn’t sleep with the pain

I have my next Rheumy appointment next week the 28th Feb.

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14 Replies
pino99 profile image
pino99

Hi,

I have been on plaquenil for three years, together with other medications. I have never felt it helps at all, but my consultant is very keen I stay on it as there is substantial evidence that it improves long term outcomes. I understood everyone is put on it from the beginning, with stronger meds to be added if needed.

Good luck with your appointment.

Bee1011 profile image
Bee1011 in reply topino99

Hello and thanks for replying.

I suppose I was hoping Plaquenil is going to be my magic drug to make me feel better. How does anyone live like this ??!! I’m forever laid up and I can’t fight it because I’ve tried and just end up feeling so poorly I’m stuck in bed or on the sofa again for days 😟

Thanks again for taking the time to reply and sorry if I sound negative I suppose I’m just not accepting and dealing with this awful disorder very well x

pino99 profile image
pino99 in reply toBee1011

Hi,

Don't apologise, I fully understand what you are going through. Hang in there, though, as my experience is that this illness has ups and downs, and there will come a time when you hopefully feel a lot better than you do now. Be kind to yourself, rest when you need to and move when you can, but without exhausting yourself. It is a fine line, I am afraid.

pino99 profile image
pino99

Also, Plaquenil works very well for some people, you may be one of them. I think you should definitely push for it and ask for a second opinion if your rheumy refuses.

Wengc profile image
Wengc

I've been on it for 3 years, it took a couple of months to kick in but has helped the pain significantly and reduced the night sweats. I have Limited Scleroderma, and take Ranitadine as well for reflux as I can't tolerate any of the others. I was reluctant to start immunesuppressants and take Plaquenil, but then I met someone with Diffuse Scleroderma, she had been on Steroids for over 5 years, had lung involvement, clawed hands....she told me that her lung condition was still poor but the rate of deterioration had reduced since taking Plaquenil, and has seen a positive improvement. She then started Mycophenolate after a year on plaquenil and was convinced both had a positive impact...that convinced me, and I am now taking both, started Myco last year....I saw a big improvement in my skin involvement with Myco, and though I have to pace myself, life is more normal.

Sorry for the long post but I asked myself what experience your Rheumy has had with treating this disease, has he treated others with it with poor results? Everyone responds differently.....it must be worth trying, if you don't you will never know! I hope this helps.

LucyJean profile image
LucyJean

Hi Bee, HCQ is a funny drug. it is an antimalarial medication, that was found to have benefits in treating people with autoimmune conditions. It is particularly used for people with Lupus, but most people with connective tissue diseases such as scleroderma are also on it. It seems to have an effect of suppressing the immune system, which is over active in people with these conditions. It also has lots of beneficial 'side effects'...it can reduce blood sugar levels, and help the vascular system, as well as having an impact on reducing immune activity. In fact the one of the Professor Rheumatologists I worked with used to say that they should put it in the water like fluoride so everyone could benefit!

It takes time to work though. It is not a quick fix. It takes at least 12 weeks to properly get into your system and start having an impact, and then there is an ongoing building effect. Many people describe most benefit after they have been on it 6months, to a year. Some people will of course find that they experience side effects, for example, with any drug you have the risk that your digestive system won't tolerate it and some people find it gives them headaches. Although if you start on the lowest dose and build up very gradually you normally find these settle. People can worry about an extremely rare side effect, which is toxicity of the retina (your eyes). The usual protocol is to get people to have an eye test before starting and then annual check ups after that.

I hope that makes all sense.

All my best

Lucy xx

Bee1011 profile image
Bee1011 in reply toLucyJean

Thank you to all of you for replying I really appreciate all your input it helps a great deal.

I was such an active bubbly person before this so I do find it difficult to pace myself and rest but I do try. Occupational Health through work have been great and the doctor there said if I don’t get any joy with my rheumatologist he will contact him to discuss a full diagnosis and treatment plan but I have to wait till I’ve been to the combined chest clinic on April 19th. I’ve had a lung function test and chest scan and they say definite lung involvement though minor at present which is good. I just think it is best to start some treatment as it takes a while to work it can always be changed as I go along.

If I still can’t get anywhere with my rheumy I will definitely ask for a second opinion.

Thanks again for all your advice.

Take care and stay well x

Bee1011 profile image
Bee1011

Afternoon everyone I hope you are all as well as you can be.

Well I had my appointment with consultant today to discuss starting on Hydroxychloroquine, I say my consultant it was his registrar as usual !! Anyway she again said Dr Patel isn’t a big believer in this drug .....why I don’t know !! As I said before if he felt like this he would try anything. She put me on 200mg once a day is this the norm ?

My bloods indicate sclero/crest but I also show signs of Sjögrens. I had a litmus test done today and my right eye which is so sore and dry was 0mm and left eye only 2mm definitely very dry ! They still think primary sclero/crest and secondary Sjögrens but still diognosed UCTD at present they seem so reluctant to pin it down to a specific thing. This is the most frustrating process I have ever been through but at least I’ve started hydroxy now fingers crossed it works for me.

Thanks for reading

Wengc profile image
Wengc

I started on 200mg, I think they work out the dosage according to your weight. It took about 6 weeks before I felt any effect, but the pains subsided then and haven't returned. Still on 200mg. I hope it works positively for you, you may h ave to give it a couple of months though. I have a regular eye check as it can affect your eyes.

Bee1011 profile image
Bee1011

Thanks for your reply. It’s good to know someone else is on 200mg a day and it made you feel better as most posts seem to say 200mg twice a day. I was told 6-12 weeks before I will feel any benefit but that’s fine at least I’ve started them now as I thought they weren’t going to give me them. The consultant mentioned the eyes and gave me a test to do and to let her know if I notice any floaters etc.

Did you notice if the tablets helped with fatigue at all ?

Wengc profile image
Wengc

It did help with fatigue I think, but I do have to pace myself and not overdo things.

Bee1011 profile image
Bee1011 in reply toWengc

I hope so as work are expecting me back if this drug works ! I don’t know what’s worse the pain or the fatigue. :-(

Take care and stay well x

FromToronto profile image
FromToronto

Hi,

Your post is a year old now so I was wondering whether Plaquenil has helped you. I was diagnosed with UCTD 8 years ago after experiencing symptoms for a year. I wasn't put on any medication for a year and a half after bring diagnosed despite having all sorts of awful symptoms and being barely functional.

Finally my rheumatologist agreed to put me on Plaquenil. I initially took 200 mg twice a day. It took about 4 months to build up enough in my system to begin working. My symptoms gradually improved over the course of that year until I felt basically normal and well again. Plaquenil has been an absolute miracle drug for me. I switched rheumatologists and my new one reduced my dose to 200 mg twice a day for 5 days out of the week. She said retinal toxicity is more likely to occur when the dose is too high for your body weight. I weigh about 120 pounds.

I felt healthy and well for 5 years on Plaquenil alone. I would have the occasional bad day when I felt achy, tired, and unwell, but they were rare.

I ended up stopping Plaquenil a year ago (for complicated reasons, mostly due to another medication I was going to take). I was curious to see whether any of my symptoms would return because I'd read that UCTD sometimes "burns itself out" and never evolves into a specific connective tissue disease. I thought maybe I was one of those lucky people with very mild disease who had gone into spontaneous remission. Nope! It took about 6 months for the drug level in my body to decrease enough for me to start showing symptoms again, but when I did it was exactly the same as when I first became sick. It was completely debilitating. This was in July 2018. After a month, I was put back on Plaquenil. August was terrible, September was a bit better but still difficult, October was about the same... By December I was feeling better but not totally well. In January I felt almost back to my old self, and this month I feel good with only the occasional symptom. So again it took about 6 months on the drug to gain the full effect.

I hope to stay on Plaquenil for the rest of my life. It works amazingly well for me. At my eye exams this year and last year, the eye doctor identified a small area of loss of pigment in my retina in my left eye. He said it was not worrisome enough for him to tell me to stop taking Plaquenil. He referred me for visual field testing every 6 months, and my results so far have always been perfect. So he said we would monitor it and see if it progresses or changes. Obviously my vision is extremely important, but if I had to stop Plaquenil I would be devastated. It has given me my life back.

I hope it's been as effective for you!

Bee1011 profile image
Bee1011 in reply toFromToronto

Hello

My goodness doesn’t time fly I can’t believe that was 12 months ago !

It is good that you have found something that works for you so I’d stick with it if I were you. Unfortunately Plaquenil gave me such awful side effects I had to stop taking it after 6 months. It made me feel sick to the stomach and terrible headaches. I carried on taking it as I was hoping they would wear off and my system would get used to it but it didn’t.

My rheumatologist has been useless. He almost makes me feel I am making it up yet my bloods are off the scale for Scleroderma. It’s as if he just can’t be bothered but I think it’s more he doesn’t know how to deal with it. I have been suffering with this for 7 years now and under this rheumatologist for a year and a half. Due to this I have decided to move to Leeds Teaching Hospital to see Scleroderma and Raynauds specialist Dr Del Galdo or Prof Buch. I am waiting for an appointment which they say I should receive by the end of Feb. Fingers crossed I can get some help there.

I suppose different things work for different people but as I said if Plaquenil works for you keep with it.

Take care & stay well 😊

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