In October, I saw my rheumatologist for my regularly scheduled appointment. We discussed my current blood work which except for white blood cells staying a little higher than she would like, everything else looked amazing. My SED rate and c-reactive protein have been consistently low and my liver looks good. She did share that the last round of hand x-rays showed some changes and she wanted to run a new blood test on me. She shared that even though I am feeling well overall and my blood work is coming back great, my RA could still be progressing and she wanted to run a newer test on me called Vectra-DA. According to their site, "Vectra DA works by measuring the levels of 12 important proteins in your blood."
It takes several weeks for the results to come back and what they sent me wasn't very detailed except to give me a number and say that my RA is now moderately active. On Friday I saw my rheumatologist to talk more about the test. First, I wanted to verify that the charges for the test would be covered. She assured me again that after insurance pays it part on the almost $1,000 bill, Vectra-DA will cover the rest. (RELIEF!!!) I then asked her if she learned enough from the test that she felt it was worth the price. She definitely did. According to my rheumy, there aren't enough tests available right now to chart our progression. SED rates and c-reactive proteins can easily be influenced by colds and other inflammation we have in our bodies. With the Vectra DA she can tell which proteins are being blocked which help her know if we are on the right track with medications. With a score of 20 or under, a rheumatologist knows they are on the right track and medications are working well. I have a score of 30, which is still good. (Yay me!) This score and the information she received allows her to see which proteins are and are not being blocked. (As someone who has fought medications for over half my diagnosis time, I still feel a little sick to my stomach thinking of something being blocked in my body on purpose. It may be blocking the RA from progressing, but I still wonder if it is blocking something that I need. Oh well, another topic for another day.) From the test she is able to see that Enbrel is working as planned for the most part. She can also tell that another protein is not being blocked and if down the line I find I am having more flares than I do now, we can switch to or add a medication that will block those proteins.
Her plan for now is to run the test every six months as long as it is being paid for so that we can see what direction my RA is going. I like this idea. I like that she has something that just might give a better picture of what is happening with my body. It gives me hope that a lot of others in pain might find the missing link to why certain medications are not working for them.
At the appointment we also discussed my trigger fingers which seem to be getting worse. She reminded me that if they get too difficult, we can do a cortisone shot. While I have accepted I need medications for now, I am still at a point that things will have to be worse for me than they are now to do an injection. As my young rheumy also reminded me of, I need to be more observant to when the trigger fingers are acting up. Is weather affecting them? Food? Stress? Unfortunately, I think it might be stress. :( I'm working on that one.
Has anyone else had the Vectra-DA? I am curious as to what others think of this test.
I haven't had this test, but I was so interested to read what you had to say about it! My rheumy has often said that my disease activity and blood work don't always seem to match up - my SED rate will be perfect and white blood counts great, but my joints will still have changes and I'll still be in pain. I'll ask her about this the next time I see her!
ReplyDeleteAlso, I'm glad you're doing so well and that Enbrel is continuing to help. That's great to hear. :)
Good luck Helen. I hope it is available to you. I hope the new job is wonderful. You have worked hard.
DeleteHelen, another reader told me this test is not available in Canada. :(
DeleteHow interesting! I wonder if we have it here - bet the NHS doesn't cover it ;) Great to hear that you're on the right track with your meds, sounds like a great idea to do this test regularly.
ReplyDeleteThanks for posting. Like Helen, my bloodwork usually comes back great even though I might not be doing so well. I see my rheumy in February and will ask her about the new test. I hope your results continue to be good and that those trigger fingers calm down!
ReplyDeleteI am glad for any new test that might help us all track down a cure for these diseases! No, I have not had this test but have found a new doc to try here where I live. And this may just be another key to help unlock this very complicated shut door for all of us.
ReplyDeleteI had this test done a year ago. My overall Vectra number on that bar graph was in the 90's. So, I was at high active rate of disease. I laughed, and said I didn't need a 1k test to tell me that. The rheumy said that I had the highest number they saw thus far. She didn't even bother to retest me in 6 months because my sed rate stays in the 70's and 80's no matter what I do or don't do. I like that a new test came out to show the progress of disease for a RA patient, but I didn't think it changed my level or care or medications.
ReplyDeleteAtotheA, sorry to hear your score came up so high. Your RA must be going crazy right now. :(
DeleteMy rheumy wanted to run the Vectra-DA on me because my blood work consistently shows up great and I am not in pain right now. However, my x-rays showed some changes occurring. She said it is a good test for someone like me because we may think RA is in remission based on current blood tests and how I feel, but find that it is still doing damage. Also, she was able to find a protein that isn't being blocked and if more pain continues, we can change medications. I hope you find something that works well for you.
I got my results today. I was in the high category by one point. So 46. I also requested copies of the labs so I could take a look myself at the different biomarkers. I could see that a couple were of a much higher percentile than the other factors. Useful information since futher research has led me to understand that one of these, at least, may require a different or additional med. I was diagnoised with RA in 2010, tried placquneil at that time for a couple of months. Side effects and the misery of dealing with my then rheumatologist were just too much so I went off and stayed off all meds until now. I recently had an epic flare that lasted MONTHS and was just barely touched by steroids. I will be starting Enbrel as soon as I can work up my nerve, lol. On a positive note: xrays taken 5 years ago and taken again this year show no joint damage. However I feel this respite is over given this new level of disease, trigger fingers and widespread tendonitis and locking elbows. Also, I nearly fainted when I got my EOB from my insurance and saw my responsibilty at $1,000.00 A call to my insurance and they told me that the lab wasn't "in network"...to which I responsed but my doctor is and this was done in house and I have no way of knowing who they send their blood woork to. Seems like the insurance company should know that about their own network doctors. Apparently this made sense to them to as they agreed and will be backing out that charge.
ReplyDeleteI have had the Vectra Da test my score is 55, waiting on insurence to approve actemra. I currently take plaquanil, methotrexate, diclofenac ? Spelling on that one, the last one is for inflammation not sure how I feel about it yet! My body is raging so I hope they find something to help and soon!, not sure how much longer I can take this, I have Seronegative RA, fibromyalgia, Tendonitis, tennis elbow, calcified tendon in both shoulders, siatic nerve issues, and some mild to moderate changes on my spine and neck. I have issues with my feet, hands wrist, elbows, shoulders, knees, lower back, neck, spine, and shoulders. There are more that is just all I can think of this minute....I wish you all the best of luck with everything you are doing to find a happy meadium with your RA or any chronic illness you may be fighting to keep under controle. Brandy
ReplyDelete