Daughter Achieves Good Results on Amevive
from Linda C.

Dear Ed, Just wanted to let you know how my daughter responded to Amevive.  She began her treatments on 3/29 and finished on 6/14.  Her beginning CD4 figure was 2420.  Her ending figure was 1764.  The lowest during her treatment was 1700.  She saw her derm yesterday (July 15), and the doctor is pleased with the results.

My daughter’s elbows, where the lesions are quite visible, have probably improved 80%.  We haven’t seen the lesions on her legs, but she says they have improved, also, with one stubborn area.  The itching has improved but only in the past several weeks. 

Actually, the improvement was not seen until completing the shots.  Her derm is going to prescribe another series of Amevive shots in 3 months if she has no rebounds before then.  If she has a rebound, she is going to put her on Enbrel.

She had only a co-payment of $40.00 a month for her Amevive treatments.  Her insurance also paid 100% of weekly lab tests.  Without insurance, Amevive would not have been an option. 

Since it is an overactive immune system that triggers psoriasis, we do not understand why your psoriasis is so severe, as your counts are so low.  Take Care.

Sincerely, -Linda C.

*****

Ed’s Response:   Great news about your daughter.  This is the second report I've received in which Amevive didn't work well until AFTER the first 12 week course was concluded.  Interesting!

More and more anecdotal reports suggest the higher a flaker's lymphocyte counts, the more likely the Enbrel/Amevive is to work.  I'd suggest this is because these T-cells are a large — but probably not singular — triggering mechanism for P.  We may yet find something "beneath" the T-cell functions, something that can exist and be of influence on skin irrespective of T-cell quantities and activities, that is more fundamental to P, but yet effected (always ... sometimes ... or for awhile) by modifying T-cell function (via the biologics).   Someone likened my thinking to this parable:

Every day the cows in the corral watch a man come and open the gate, after which the cows file out to the pasture until evening, when they're herded back into the corral by the man, who closes the gate behind them.  This goes on for generations of cows.  One day, twilight comes to the pasture and the cows begin to notice, one by one, that there is no man there to herd them back to the corral.  Instinct steps in and they return to the corral on their own.  No man closes the gate behind them, but there they stay through the night, and the next morning they go out, and the next evening they come back.  The man is T-cell CD4 function and the going and coming of the cows is the waxing and waning of P.  The moral is self-evident. 

What did this little parable mean to me?  I want to switch to farming and quit cattle ranching altogether!  <wink> -Ed

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