RA Case Studies
A closer look at the KINERET patient
The following case studies illustrate the experiences of 5 patients with difficult-to-treat RA and how those experiences led them to treatment with KINERET.
Discover the role KINERET has played in 5 examples of difficult-to-treat RA
Patient Case Study
A patient’s perspective
Megan began treating her multidrug-resistant RA with KINERET in 2013.
“Compared to how I felt when I was diagnosed, and during the 5 years after, the change is heartening.” - Megan
Signs of inflammation
- Severe polyarticular joint pain
- Severe rash (vasculitis), initially on legs and spreading
- Fatigue
- Fever
“These years hold some of the darkest moments of my life. I ‘failed’ one drug after another. I started slowly losing my hair, my independence, and my optimism for a future without pain.”
Treatment failures
August 2011, aged 31:
- Treatment initiated with nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and a traditional DMARD
2011-2013:
- Trials with 2 additional traditional DMARDs failed
- Symptoms partially managed with NSAIDs, corticosteroids, and original DMARD
“In my case, since beginning treatment with KINERET, the joints in my hands and my feet became less tender and painful. It has also helped control my frequent low-grade fevers, and my skin rashes have improved.”
Treatment with KINERET
June 2013:
- Treatment with KINERET initiated based on symptom profile
- Megan continued to receive corticosteroids and traditional DMARD
2019:
- Megan continues treatment with KINERET
This case represents one patient's experience as interviewed in 2017. Individual outcomes may vary and are dependent on a patient's clinical history and profile, as well as their treating physician's discretion.
Expand Case Notes
Date
NOTES
-
- Referred to rheumatologist for joint pain, rash, and fever
-
- Diagnosed with RA
- Treated with NSAIDs,
corticosteroids, and traditional
DMARD
Trials with 2 additional DMARDs -
- Started KINERET treatment
-
- Continues KINERET treatment
A clinical case study
Dr. Edward Ewald relays his case of a male patient with difficult-to-treat RA, initially diagnosed at age 49.
“The patient’s symptoms definitely improved on KINERET....He’s not had any complaints of painful joints. He’s been under relatively good control.” - Dr Ewald
Physician Edward Ewald, MD Adult rheumatologist Patient 49-year-old male
Symptoms
- Moderately severe joint pain
- Swelling and tenderness of multiple proximal interphalangeal and metacarpophalangeal joints,
metatarsophalangeal joints, shoulders, and knees:
- Swollen joint count: 8
- Tender joint count: 8
- Symmetrical polyarthritis affecting large and small joints
- Difficulty with day-to-day functioning
- Positive rheumatoid factor
- ESR of 115
Diagnosis
Rheumatoid arthritis
Treatment history
Prednisone, hydroxychloroquine
↓
Tapers prednisone, adds nabumetone
↓
Adds methotrexate
↓
Initial biologic with treatment failure
↓
KINERET
“We talked about KINERET because it had a short half-life.”
Complicating conditions
- Poststreptococcal glomerulonephritis
- Successful renal transplant
- Current osteoarthritis
Results with KINERET
- Swollen joint count: 0
- Tender joint count: 0
- ESR: 2
- CRP: 6.20
This case represents one patient's experience. Individual outcomes may vary and are dependent on a patient's clinical history and profile, as well as their treating physician's discretion.
Expand Case Notes
Date
NOTES
-
- Diagnosed with RA
- Prescribed prednisone and hydroxychloroquine
- After 9 months, tapered off prednisone, continued hydroxychloroquine, and began nabumetone
- Patient refused methotrexate
- Symptoms persisted
-
- Began treatment with methotrexate
- Symptoms persisted
-
- Began treatment with initial biologic
- Experienced intermittent pain and swelling
-
- Hospitalized for group A strep infection in foot
- Renal failure
- Kidney biopsy showed poststreptococcal glomerulonephritis
- Stopped treatment with biologic
- Started hemodialysis
-
- Renal transplant
- Ended hemodialysis
- Began treatment with KINERET
- Symptoms improved (swollen and tender joints)
-
- Continues KINERET treatment
A nurse’s story
Peggy, a registered nurse living with difficult-to-treat RA, treated her symptoms with KINERET.
Peggy’s symptoms began at a busy time in her life.
“My symptoms started in 1993, the day before my daughter’s fifth birthday. I started to get really achy, almost flu-like. I got up in the morning with difficulty moving anything...As time went on I continued to work, because if you’re not getting better, you just have to go with it. I wasn’t a complainer, but people could see that I was suffering.”- Peggy
For years, doctors were unable to find a treatment that worked for Peggy.
“I tried many different treatments to get my symptoms under control, but many of them didn’t work for me and I had a hard time tolerating them...I started to worry. What if nothing could help me?”
But her rheumatologist was unwilling to give up.
“With multiple therapeutic failures, my rheumatologist continued her search for a treatment. She attended a rheumatology conference with me and my RA diagnosis in mind. She came back and said ‘I have something for you.’ That’s when I started KINERET.”
Peggy experienced a reduction in her symptoms after starting KINERET.
“The fatigue and the aching in my joints started to improve...My RA symptoms abated within 12 weeks and didn’t return as long as I was compliant with the dosage and the maintenance schedule.”
This case represents one patient's experience as interviewed in 2018. Individual outcomes may vary and are dependent on a patient's clinical history and profile, as well as their treating physician's discretion.
Altering the RA regimen
The case of Christine, a 46-year-old woman with a 3-year history of RA who achieved measurable RA improvement after starting on KINERET.
Signs and symptoms
- 6 swollen joints, 12 tender joints
- ESR: 28 mm/hr
- General health (visual analogue scale, VAS): 50
- Headache
- Debilitating fatigue
Diagnosis
Rheumatoid arthritis
Treatment history
Prescribed MTX and a short-term, low-dose corticosteroid
↓
Short-course steroids to treat flares
↓
Anti-TNF with MTX x 2
↓
KINERET with MTX
Complicating conditions
- Failed to ever achieve a satisfactory response
- Poor response to steroids
- Persistent flares, including signs/symptoms associated with autoinflammation
Results with KINERET
- Christine is prescribed KINERET
- Anti-TNF is stopped and MTX continued
- Christine has symptomatic relief and improvement in ESR
- Christine remains on KINERET and MTX; RA symptoms continue to be well managed
This case represents one patient's experience. Individual outcomes may vary and are dependent on a patient's clinical history and profile, as well as their treating physician's discretion.
Expand Case Notes
Date
NOTES
-
- Diagnosed with RA
- Prescribed MTX and short-term, low-dose corticosteroid
- Diagnosed with RA
-
- Persistent joint pain, fatigue, and fevers; short-course steroid prescribed to address flares with minimal effect; evidence of elevated glucose
- Initiated anti-TNF treatment with MTX, resulting in partial relief
- Symptoms returned; switched to another anti-TNF
-
- Diagnosed with diabetes, well managed with metformin
- Persistent fever with rash and headache
- Autoinflammatory etiology suspected
- Discontinued anti-TNF
- Initiated treatment with KINERET and MTX
-
- Continues successfully managing her RA with KINERET and MTX
Adding KINERET to a complicated case
A look at how one 60-year-old RA patient with accompanying complicating conditions found success with KINERET.
Signs and symptoms
- 3 swollen joints, 16 tender joints
- CRP: 40 mg/dL
- General health (VAS): 60
- Mild bone erosion on radiograph
- Debilitating fatigue
- Complicating conditions: obesity, diabetes, hypertension, and dyslipidemia
Diagnosis
Rheumatoid arthritis
Treatment history
DMARD monotherapy
↓
DMARD combination therapy
↓
Anti-TNF + MTX x 2
↓
non-TNF biologic
↓
KINERET + MTX
Complicating conditions
- Multiple complications
- After several failed attempts at control, success with anti-TNF + MTX complicated by signs of fluid overload (dyspnea) and suspected acute heart failure
- Anti-TNF discontinued, resulting in exacerbation of autoinflammatory signs and symptoms
Results with KINERET
- KINERET added to MTX; symptomatic response restored
- CRP improved (10 mg/dL)
- Radiograph showed no significant progression of bone erosion
- Symptomatic benefit achieved
This case represents one patient's experience. Individual outcomes may vary and are dependent on a patient's clinical history and profile, as well as their treating physician's discretion.
Expand Case Notes
Date
NOTES
-
- Diagnosed with RA
- Prescribed DMARD monotherapy
-
- Signs and symptoms persist and worsen
- Initiates and fails series of approaches: DMARD combination, followed by anti-TNF with MTX
- Switched to second anti-TNF (with MTX)
-
- Diagnosed with acute heart failure; anti-TNF discontinued, with loss of RA control
- Non-TNF biologic prescribed
- Worsening joint pain
- Recurrent fevers, headache, and rash
- Elevated CRP
- Autoinflammatory etiology suspected
- Initiates KINERET with MTX
- Resolution of autoinflammatory symptoms with good pain control
- CRP improves
-
- Continues successfully managing his RA with KINERET and MTX
- Occasional flares managed with short-course steroids
- Patient reports fewer fevers and less fatigue
- No significant progression of bone erosion noted on radiographs