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- Treatment for antisynthetase, again,
depends on what symptoms the patient has
and what organ systems are affected.
In general, all the treatments we're giving a patient
are lowering their immune system.
So, recall, we believe that this syndrome
is caused by an overactive immune system.
For reasons we don't quite understand,
the immune system is attacking the muscle,
it's attacking the lung, it's attacking the joints.
So, we need to calm it down.
There are a number of medications we use to do that.
Most patients will be familiar
with things like steroids, which is a type of chemical
that we put into the body.
Prednisone is another name for it, corticosteroids.
There are a lot of different types of steroids
the patients can receive.
But, most patients will be at some point on steroids.
Other medications include things like methotrexates,
azathioprine, mycophenolate, or rituximab.
There are actually several medications
that we have and all can be very effective
at treating patients, again, depending on what they have.
For instance, if a patient has a lot of joint disease,
it's very common for them to be
on things like methotrexate or azathioprine.
If a patient has a lot of lung disease,
it's common for them to be on mycophenolate or azathioprine.
So, there is some overlap, if you kind of envision
a Venn diagram of certain medications for certain symptoms.
But, for the most part, it's important to know
what's affected so we can target that as much as possible
with the medications we use.
One thing patients should be aware of
is these medications take a while to work.
So, it's very different than taking a Tylenol,
taking an aspirin, where you take it
and expect an effect in four to six hours.
These medications do not work that way.
They take a long time to build up in the body,
achieve a steady state, and actually exert their effect.
So, upwards of two to three months,
and sometimes even longer, these medications can take
to have their full effect.
So, patients shouldn't be discouraged
or demoralized after a couple weeks
when they don't really feel like they're having a response
because it can take a little bit of time.
The exception to that is steroids.
They usually see a sooner response with steroids.
As most patients know, steroids has a lot of side effects
the longer you're on them.
So, while they're helpful upfront
and usually are used early in the diagnosis,
we try to get them low, if not off,
as soon as possible in all of our patients.
Most patients will need to stay on their medications
for at least a few years.
It varies greatly depending on the patients.
But some patients will need to be
on these medications for their life.
Other patients are able to come down
in the dose of the medication they're on
over a few years and even be on very low doses
or a small group of patients will even be able
to be totally discontinued.
Unfortunately, we don't know which patients
will be the ones that are able to come down
on their medications or just simply
discontinue them over time.
But, studies are underway to address that very question.
Another thing patients should be aware of
is that when they're on these types of medications,
these immunosuppressing medications,
they're going to need to get monitoring blood work.
This blood work is done just to make sure
the patient's tolerating the medication okay
and doesn't have any signs of toxicity.
So, depending on the medication,
that kind of dictates what the side effects are.
But, in general, blood work will be required.
When we start the medications,
we tend to check blood work a little more frequently
just because it's a new medication,
we're increasing the dose over time.
We want to make sure they're doing okay.
So, usually every few weeks or so, we'll get blood work.
However, once a patient's on a medication
at steady, they've been tolerating it for a few months now,
they can space out their frequency of blood work
for every three months or so as an average interval
which we go with.
We also encourage patients to receive vaccinations.
They can receive those vaccinations,
at least specific vaccinations,
even if they're already on immunosuppressing medications.
So, the two we recommend is a yearly flu shot
as well as a pneumonia vaccine.
To get a little bit more information
as to who and when, we actually have a video
for vaccinations that you can reference.
And you can look at that after this video completes.
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