Rheumatologist: “I pushed alot of … poisons.” Didn’t help patients.

This physician, quoted below from a medical journal, is wow’d by the massive changes that have occurred in the treatment of RA in the past 10-20 years, meaning the increasing use of biologics. Most fascinating is his statement that standard practice in earlier years was ‘poison.’

Does it make you wonder what the current reliance on biologics will be called in the future?

He also repeats the currently popular medical dogma that biologics induce remissions. In the past the word remission meant that symptoms disappeared spontaneously. Rheumatologists today say that the vanished symptoms typical of remissions can be the result of a drug and last only as long as the patient takes the drug – and as long as the drug is effective.

That’s like saying that taking an NSAID for a strained muscle puts the strain in remission. The damage is either there or its not. Conditions like a muscle strain can be temporarily disguised by pain medication but until the muscle heals itself, there is an ongoing problem.

We’ll have to dissect the warping of the word ‘remission’ as applied to Rheumatoid Arthritis in another post.

If you go to the link below (you will have to register with Medscape) be sure to read the responses this doctor generated. Interesting.

Wow… have things changed in RA!

Nathan Wei, MD, Rheumatology

When I first started practice in 1981, I pushed alot of gold, penicillamine, and other poisons I’m too embarassed to mention. Procedures like lymphapheresis and total nodal irradiation were written about. Our patients still didn’t do that great.

MTX was an improvement but biologics really changed the game.

Remission is expected now. In fact, if I have a patient where I don’t get at least a partial remission, I think I’m doing something wrong. I’m terribly disappointed.


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