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    RA treatment in patient with positive TB test.
    avatar
    catuscandy posted:
    I was diagnosed with RA 1 1/2 yrs. ago. In the beginning I had little symptoms. Now my fingers are misshapen, thick, and I cannot make a fist without pain. I have a positive TB test and cannot take any biologicals. I'm currently on Plaquenil with fair control, but it makes my hair fall out and my muscles turn to sponge. What are my treatment options? My ccp readings are always greater than 500. I've had some flares that make it impossible for me to drive a car.
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    avatar
    allie_bf responded:
    Certainly you will want to talk to your doctor about your options, but your positive TB should not disqualify you from all RA therapies. Methotrexate is probably your next step-up from Plaquenil. No doubt your doc will want to see a clean chest x-ray, and will probably want more labs, but past exposure to TB is not an automatic no-go. Chances are, your doc would have you try methotrexate before the biological anyway, as that seems to be the typical progression. Good luck, and hope you feel better.


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