I'm Tigerlady. I'm 39 and was just diagnosed with AS. I'm HLA 27 negative. I've had chronic recurrent anterior uveitis for 3 years. I've tried all the meds: prednisone of course, has actually given me cataracts in both eyes. Waiting to have surgery. Had a horrible reaction to mtx injection. Been on Humira for 2 months. It's been great until the past week. I've had 2 flares of eye pain, and 1 flare of joint inflammation with pain. Is this normal? Please give me some information on this problem. Thanks

Hi Tigerlady,

I start with Humira too. It's not very well but I have to start to take Mtx, is necesary like co treatment with Humira. If not the Humira´s antibodies attack our body.

This can happen on the biologic meds. Just be gentle with yourself when it happens. As to the biologic's effect on anterior uveitis (iritis) I don't know Humira's response on this. I do know that I haven't had a flare up of iritis since starting on Remicade (infliximab) 10 years ago and then switching to Enbrel (etanercept) five years ago. It might be worth looking into.

Warm hugs,

Hello, Tigerlady:



I don't have direct experience with any biologic, but like them very much for their potential to reduce symptoms. Two months should not be long enough to develop antibodies to the Humira.

The agent provocateur in AS is the immunoglobulin IgA-Kp, produced in response to the presence of the bowel germ Klebsiella pneumoniae. This IgA reacts with most of our collagen tissues, especially type IV--that of which the uvea, lens capsule and other eye components are composed.

Regret our nemesis germ thrives upon our favorite foods, and I don't want to drive Your opinion about what You ate prior to the iritis flare; it is something to consider. There are a limited number of cytokines the biologic can neutralize, but the numbers of IgA we can produce are prodigious and can easily overwhelm. And just one IgA can eventually result in the production of many target (and non-targeted) cytokines.

I hope the "eye pain" You have experienced is not iritis, but in every similar situation I highly recommend a dietary approach in conjunction with every other therapy.

HEALTH,
John

Thanks, for the feedback on watching what I eat. I did eat a pumpkin little Debbie cake on Friday evening. After that is when all this started again. I had been very careful about what I was eating. Makes sense. I've been reading the book on ibs dieting starch. I'm learning a lot. Thanks again.