Tracie Seimon bikes with her doctor, John Hardin, left, and her husband, Anton Seimon.(Photo: Handout)
John Hardin reflects on the 525-mile scenic bike ride he took along
the West Coast with Tracie Seimon and her husband in October. They
started in San Francisco, headed south to Los Angeles and rode eight
hours a day for eight straight days.
Not exactly what he pictured
when Hardin met Seimon two years ago. She was 37 and turned to Hardin, a
prominent rheumatologist in New York, for help. Other physicians had
not been able to diagnose the cause behind a crippling pain that started
in her feet, spread to other joints and was accompanied by swelling,
fatigue and fever.
"When I see patients in that condition, I am
concerned they might end up in a wheelchair,'' says Hardin, vice
president of research for the Arthritis Foundation. "She was having
trouble walking and needed assistance going upstairs. People don't need
to suffer like that anymore."
After examining her health history
and running tests, he diagnosed rheumatoid arthritis and put her on an
aggressive new drug therapy. The therapy took several months to start
working, but she's currently in remission from an inflammatory disease
that affects 1.5 million people in the USA and can eventually cause loss
of function. It is an autoimmune disease, which means the immune system
mistakenly attacks tissues. It can also attack the heart and lungs.
am so grateful,'' says Seimon, who lives in Nyack, N.Y., with husband
Anton Seimon and their two dogs. "The drugs made me a little nauseous at
first, but my body has gotten used to them, and I seem to be tolerating
them well now."
She's back doing the field work she loves. A
conservation researcher at the Bronx Zoo, she travels to remote
destinations in search of pathogens that kill wildlife.
to be strong to do my job,'' she says. "I am often working at high
altitudes and flipping over big rocks looking for amphibians." She's
looking forward to upcoming field work in Russia, Peru and Vietnam.
drug regimen she's on includes Enbrel and Methotrexate, which both work
on the immune system by blocking or reducing the proteins contributing
to the disease process. Plaquenil was developed to treat malaria,
Hardin says, but it is also effective in treating early RA.
who begin treatment within two years of the disease appearing can
expect to have low or moderate disease activity with the new treatments,
rather than merely relief from symptoms, says Hardin. In a study of 682
people with RA, more than 75% of those treated with Enbrel and
Methotrexate experienced no progression of joint damage after three
years. The therapies are delivered by injection or infusions.
new therapies are in the pipeline. The Food and Drug Administration
recently approved Tofacitinib, a new class of oral drugs for people with
moderate to severe rheumatoid arthritis who haven't been helped by the
other therapies. Tofacitinib works by suppressing the immune system,
according to the National Institutes of Health.
Not all drugs have
been successful; last week, Eli Lilly said it stopped a late-stage
trial of the experimental drug Tabalumab because an interim analysis
showed it was not working. Lilly said the move was not based on safety
concerns; two other late-stage trials of the drug, seen as an
alternative for patients who were not helped by Methotrexate, are
continuing, as are other smaller studies.
Seimon must remain vigilant to protect herself from getting sick, since her immune system is depressed by the treatments.
always washing my hands and doing everything I can to make sure I don't
get sick in the first place,'' she says. "I'm careful about what I eat
and make sure I get enough sleep."
She had one flare-up when she
experimented with tapering off the drugs before the October bike ride,
but resuming the therapy eliminated the problem. She plans to take them
for the long haul. The long-term effect of the drugs is unknown.
my choices weren't good ones,'' she says. "Looking at what the
alternatives would be, I'd have no life and I wouldn't be doing my
research that I love to do on frogs."