PITTSBURGH (KDKA) – Chronic pain, like the kind associated with arthritis, not only hurts, but can also be frustrating and depressing when it limits your ability to do the things you used to do.
However, there might be a way to finally get relief.
Commissioner Daryl Mitchel has a chronic, painful condition in his fingers and wrists.
Because of rheumatoid arthritis, opening jars, tying his shoes, buttoning his shirt — simple things are painful, challenging tasks.
“It’s like a throbbing toothache. It doesn’t go away,” Mitchel said.
He’s tried steroids, chemo drugs, pills and injections targeting the immune system.
No one knows why rheumatoid arthritis happens, but it seems some sort of trigger — maybe smoking, an infection, or trauma — sets off an autoimmune reaction in the joints. The tissue there gets thick and deformed. Even cartilage, tendons, ligaments, and blood vessels can be affected, too.
Daryl’s doctor offered him a new drug — xeljanz.
It works in a way all the others before it do not. It blocks certain enzymes important to inflammation.
In studies, people have had fewer swollen, painful joints, improvement in blood tests checking for inflammation and better function.
“I’ve had several patients who have found that this drug has been effective for them. They failed many other medications, including shots, IV, different combinations of oral medication, so I’ve been pretty impressed with its effects,” Dr. Fotios Koumpouras said.
But it costs $24,000 a year. Drug companies offer programs to help patients get the drug.
“It is very expensive, but it is similar in cost to some of the newer medications, and if you look at cost-effectiveness, if people can’t work, it’s a loss to society,” Dr. Koumpouras said.
Doctors have to watch blood counts, which can go down, and cholesterol levels, which can go up. Long term effects on the bones aren’t known yet.
Infection, cancer, and intestinal complications are potential concerns.
While it is FDA approved in the United States, Europe has chosen not to approve it, mostly because of the infection risks.
“Europe is never crazy about expensive medications. And yes, we should realize that tuberculosis is much more common in Europe than in the U.S.,” Dr. Koumpouras said.
Mitchel hopes for more than just the status quo.
“I’m hoping this will give a little improvement,” he said.