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Re: AJAO/systemic talk

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Hi ,

Haven't heard from you in a long time.I hope Ezra is atleast stable right now.

SoJRA is a variable disease between mild and very severe.

The rheumy speaking was very opinionated but VERY agressive.

Her opinion was first of all NEVER,EVER put a systemic child on Plaquenil

because it can cause Macrophage activation Syndrome.She infuriated me but then

again she spent all the years in medical school.

If systemic symptoms have not been present for some time TNF inhibitors are

worth a shot and can work well.

Kiniret seems to work much better on SoJRA then TNF inhibitors unless a child

has Poly JRA.

Interlukin 6 is a major role in SoJRA and the trial drug MRA is being studied

in Japan.I first heard about this drug when was still on the waiting

list for Enbrel,from Georgina of cource.At the time it was being studied in

adults only.They learned that the average adult RA patiant had very little

responce but the ones that had body wide(systemic)disease,it was remarkable,My

heart

sunk just knowing that it would be droped,due to the lack of responce.

It is very important to look into CARRA because unless I heard wrong they

have no interst in clinical trials beyond Asia and Europe.This has been refered

in Japanese papers as a cure for SOJRA.Cincinnati childrens told us had a

50/50 chance of responding to Enbrel because Interlukin 6 is the key bad guy.

The session on SoJRA got way off topic,which was very dissapointing to us,so

much time was wasted talking about things that were important but way off

topic.

The highly opinionate DR. said that if MTX didn't work,add Enbrel,then add

Cyclosporine,then add Cytoxin(Nasty)Then add some kind of infusion,IVIG,some

sort of immuglobin ,then do stem cell transplant.MRA will someday be the

standard

drug therapy for SoJRA,but is several years away.Imposible if the drug

companies don't want to do trials in the USA.Support CARRA and gave a good

description of what it was.

To close,

some children will always need a maintinance dose of steroids but her theory

was also something I have never heard of.

You give a very large dose for 4-5 days then nothing for 3 weeks,she was also

talking oral,not IV pulse.Very upsetting for Val.You keep doing this until

you can do the high doses further apart and taper that way.

Coleen may be new but is highly educated and I am sure as soon as she gets

used to how things work can explain better.She will be a HUGE assest to this

list.

Hugs

Becki and 6systemic

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Hi Folks,

Thanks for all the feedback from the conference. I wasn't able to attend

this year, but I'm interested in the talk about systemic jra. If anyone went

to that talk and could write about what was said, I'd really appreciate it.

Thanks, and good to hear that the conference went well. (and Ezra, 8

year old systemic)

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Hi Becki,

Thanks so much for the run down on the talk. It seems like this doctor is

not only aggressive in how she treats arthritis, she is also aggressive in

how she treats people:) It sounds like the parents who were at the talk knew

more about meds (and had more opinions about them) than the doctor thought

they should. I would have found that frustrating. What is CARRA? I haven't

heard of it. Ezra is doing well. He is taking remicade, mtx, thalidomide and

Arava, which in my opinion is quite a lot of medicine. But he's going to

camp, running and playing and doing well. He has been off of prednisone for

a year now, and has gotten taller and thinner, which is wonderful to see. I

appreciate you taking the time to tell me about the talk. I hope to go to

the Rhode Island conference next year. (and Ezra, 8 year old systemic)

On 7/29/04 1:51 AM, " Arthurnator@... " <Arthurnator@...>

wrote:

> Hi ,

> Haven't heard from you in a long time.I hope Ezra is atleast stable right now.

> SoJRA is a variable disease between mild and very severe.

> The rheumy speaking was very opinionated but VERY agressive.

> Her opinion was first of all NEVER,EVER put a systemic child on Plaquenil

> because it can cause Macrophage activation Syndrome.She infuriated me but then

> again she spent all the years in medical school.

> If systemic symptoms have not been present for some time TNF inhibitors are

> worth a shot and can work well.

> Kiniret seems to work much better on SoJRA then TNF inhibitors unless a child

> has Poly JRA.

> Interlukin 6 is a major role in SoJRA and the trial drug MRA is being studied

> in Japan.I first heard about this drug when was still on the waiting

> list for Enbrel,from Georgina of cource.At the time it was being studied in

> adults only.They learned that the average adult RA patiant had very little

> responce but the ones that had body wide(systemic)disease,it was remarkable,My

> heart

> sunk just knowing that it would be droped,due to the lack of responce.

> It is very important to look into CARRA because unless I heard wrong they

> have no interst in clinical trials beyond Asia and Europe.This has been

> refered

> in Japanese papers as a cure for SOJRA.Cincinnati childrens told us had

> a

> 50/50 chance of responding to Enbrel because Interlukin 6 is the key bad guy.

> The session on SoJRA got way off topic,which was very dissapointing to us,so

> much time was wasted talking about things that were important but way off

> topic.

> The highly opinionate DR. said that if MTX didn't work,add Enbrel,then add

> Cyclosporine,then add Cytoxin(Nasty)Then add some kind of infusion,IVIG,some

> sort of immuglobin ,then do stem cell transplant.MRA will someday be the

> standard

> drug therapy for SoJRA,but is several years away.Imposible if the drug

> companies don't want to do trials in the USA.Support CARRA and gave a

> good

> description of what it was.

> To close,

> some children will always need a maintinance dose of steroids but her theory

> was also something I have never heard of.

> You give a very large dose for 4-5 days then nothing for 3 weeks,she was also

> talking oral,not IV pulse.Very upsetting for Val.You keep doing this until

> you can do the high doses further apart and taper that way.

> Coleen may be new but is highly educated and I am sure as soon as she gets

> used to how things work can explain better.She will be a HUGE assest to this

> list.

> Hugs

> Becki and 6systemic

>

>

>

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Hi ,

took wonderful notes and her post on Carra came through just a day or

two ago.She explains it much better then I can but I did pick up all the

literature it's just finding it.I will hunt for it today.

Try not to worry about Ezras drug regimine.He's up and moving and having

fun.We don't know what these drugs might do to our children in the future but we

also know what can happen to them now if the disease is left out of control.

Hugs

Becki and 6systemic

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