Recently developed medication gives new hope to patients with rheumatoid arthritis

"Out of nowhere, we now have this treatment that works so quickly. Patients have more energy. They ache a lot less, and they can do a lot more."

Paul Peloso, M.D.

For the past three years, Terry and Stineman have been joined by Lori Miller, R.N., a University of Iowa Community HomeCare nurse. With Miller's assistance, the two receive intravenous treatments of Remicade‚, a recently developed medication for the treatment of patients with rheumatoid arthritis. For Terry and Stineman, the drug's impact has nearly been miraculous, dramatically improving their daily lives.

Six years ago, Terry had begun experiencing severe swelling in her hands and feet. As the swelling and pain increased, Terry's primary physician at UI Family Care, Wapello, referred her to University of Iowa Hospitals and Clinics, where rheumatology specialists diagnosed her with rheumatoid arthritis.

Affecting 2.1 million people in the United States alone, rheumatoid arthritis is an inflammatory disease in which the joint space between bones narrows, leading to erosion of bones at that space. The disease results in pain, stiffness, swelling, and loss of function in the joints.

Although she was prescribed several medications, nothing seemed to work. Terry soon found herself hardly able to walk, let alone work outside in her yard and garden. "I've been on about everything out there, and I was just not able to do anything," Terry said.

The same was true for others with rheumatoid arthritis at that time. Terry's longtime friend, Gary Stineman, started facing some of the same problems with unexplainable pain and swelling, especially in his ankles and feet, about a year later.

"My ankle looked like a soccer ball," Stineman said. "I've had pain before, but that ranked next to excruciating."

Stineman's primary physician in New London, Iowa, William Vaughan, M.D., referred him to Scott Vogelgesang, M.D., a rheumatologist at UI Hospitals and Clinics. Like Terry, Stineman had tried different medications. His pain worsened to the point where he could barely get out of bed in the morning.

Just when it appeared there was no hope for relief, Terry's UI rheumatologist, Paul Peloso, M.D., told her about a study involving a new type of treatment for rheumatoid arthritis. Initially designed to fight inflammation caused by Crohn's disease, the medication Remicade‚ also slows the joint damage in rheumatoid arthritis since both diseases result from the same inflammation-causing chemical. Anxious to see if this might provide some relief, Terry eagerly agreed to be a part of the study group.

Like many other patients receiving the treatment, Terry's pain lessened immediately, something even doctors did not believe was possible five years ago. The swelling in her joints quickly decreased as did the pain and stiffness associated with it.

"We were just wanting to get patients by," Peloso said. "We weren't expecting perfection."

The treatment gave hope not only to patients with rheumatoid arthritis, but also to rheumatologists who were running out of relief options for their patients.

After the study, Stineman started receiving Remicade‚ as well. Together, Terry and Stineman were making trips to Iowa City every six weeks to receive their treatments. Eventually, the treatments became available directly in their homes through UI Community HomeCare, a full-service medical equipment and infusion services provider serving all of Iowa, western Illinois, and northern Missouri. UI Community HomeCare's nursing staff has expertise and certifications in PICC/midline insertion, chemotherapy, pediatrics, cardiac, bone marrow transplant, infusion therapy.

Today, both Terry's and Stineman's lives have completely turned around.

"I can do whatever I want," said Terry, who spends much of her time outside in her garden and chasing after her grandchildren. "I couldn't live without it."

For more information about Remicade‚ or rheumatoid arthritis, patients and families should contact UI Health Access and ask for the rheumatology clinic. Physicians seeking consultation or referral should call UI Consult.