Dr. Roach Urges RA Specialist Care, Weighs 3 PCSK9 Alternatives for 99-Year-Old
Updated
Updated · Detroit News · Jul 27
Dr. Roach Urges RA Specialist Care, Weighs 3 PCSK9 Alternatives for 99-Year-Old
1 articles · Updated · Detroit News · Jul 27
Summary
Biologic rheumatoid arthritis drugs can help patients who fail standard treatments, but Dr. Roach said they are generally used later because they can trigger serious infections including tuberculosis, pneumonia, hepatitis B and sepsis.
RA treatment should be guided by a rheumatologist balancing disease activity, blood-test results and medication risks, he said, adding that allergic reactions to biologics are uncommon.
For a 99-year-old heart patient with hip pain on a PCSK9 inhibitor, Roach said the drug should not be blamed until other causes such as arthritis or a torn labrum are ruled out with imaging.
If the pain stops when the medicine is paused, he suggested trying another of the 3 PCSK9 inhibitors—evolocumab, alirocumab or inclisiran—or switching to bempedoic acid, with quality of life the priority at that age.
Could the very drugs designed to cure joint pain unleash life-threatening infections, and how do doctors decide who takes the risk?
If a popular cholesterol drug causes crippling pain, could a little-known alternative that bypasses muscle activation be the ultimate secret to relief?
Why is a 99-year-old still taking aggressive cholesterol medication, and when does the pursuit of longevity actually destroy quality of life?