December 25, 2015 at 12:33 pm #454440
I have been treating an autoimmune disease with the characteristics of Psoriatic Arthritis since the beginning of 2008. Currently I have been doing well with 100mg of Minocycline 4 days a week and Azithromycin 250mg 3 days a week. I also take Methotrexate 7.5mg weekly. I have not been in any static pain and only had a few pain hot spots on physical activity. 6 weeks ago I started 400mg Pentoxifylline twice a day for another condition. Recently I have found that my pain hot spots have gotten much better. Doing research on Pentoxifylline I found it had been used in the mid 1990’s as a TNF inhibitor for RA patients. Enbrel was approved in 2004 for the same purpose. I get the pentoxifylline at no cost from my Humana prescription plan. I never would be able to afford Enbrel. Has anyone had any experience with Pentox.?
Psoriatic Arthritis: Plaquenil 200mg daily; 100mg Minocycline TABLET daily; twice daily 400mg Pentoxifylline;100mcg Levotyroxine; Have been using some level of Minocycline since 2008December 27, 2015 at 4:45 am #454446
This is a very interesting post. This drug sounds akin to Otezla, which was developed for psoriatic arthritis in that it regulates cAMP intracellularly and through this process mediates TNF and down regulates pro-inflammatory cytokines and up regulates anti-inflammatory cytokines. I have to leave for work so I will investigate later. So unlike biologics as we know them, this works without injections and attacks the inflammation mechanisms on several levels. This post is a gem and thank you for sharing!
It was used for RA, but perhaps overlooked for PSA?January 4, 2016 at 4:13 pm #454514
Have you ever researched Pentoxifylline?
Psoriatic Arthritis: Plaquenil 200mg daily; 100mg Minocycline TABLET daily; twice daily 400mg Pentoxifylline;100mcg Levotyroxine; Have been using some level of Minocycline since 2008January 5, 2016 at 1:26 pm #454532
I’ve taken Pentoxifylline sometime in the past. I don’t recall it helping me.
Another old med you may want to add to your research is Metformin. I believe it may inhibit IL-17 which is one of the targets of some of the newer biologics. It may impact other ILs too, I didn’t get too far into it. Here’s one mouse study:
I’m still on Humira, it’s really helping. I actually felt good enough after about a month to train for a 5K which I “ran” on Thanksgiving. My running still resembles “walk dead”, but it’s relatively pain free, at least joint pain free. Oh and I can jump again, not high, but I can jump. My family thought I was completely nuts when I first showed them. Apparently jumping isn’t that big of a deal if you can actually do it. So far so good.
Hope you are well,
ToddJanuary 5, 2016 at 3:17 pm #454534
Thanks for your response Todd. I know what you mean about jumping being a great feat for use. I used to hate to exercise and do the treadmill until I was in too much pain to even try. Now I am pleased as punch to get 30 minutes on the treadmill and work on my range of motion on the gym weight machines. The gym has helped me get back into a pretty good golf game. I don’t try to play every day, but 2 or 3 times a week is okay for me. Not currently having to use any NSAID’s and have stopped all Prednisone.
Psoriatic Arthritis: Plaquenil 200mg daily; 100mg Minocycline TABLET daily; twice daily 400mg Pentoxifylline;100mcg Levotyroxine; Have been using some level of Minocycline since 2008January 5, 2016 at 11:11 pm #454540Linda LParticipant
I think it is a strong painkiller so it helps with pain.
RA tried everything: Methotraxate, Arava, Humira. Pneumonia three times. Anemia. Very low iron. Hypothyroidism
AP from April 2014 till August 2015. No luck.
Current medications: Natural thyroid, Mobic, LDN, supplements incl. milk thistle, NAC, vitamins and minerals.
MTHFR heterozygousJanuary 6, 2016 at 9:52 am #454541
Wow, exercise and no NSAIDs or Pred, it sounds like AP is working well for you Vinny!
ToddJanuary 7, 2016 at 4:42 pm #454563
Apremilast (brand name Otezla) is an orally available small molecule inhibitor of phosphodiesterase 4 (PDE4). Apremilast specifically inhibits PDE4 and inhibits spontaneous production of TNF-alpha from human rheumatoid synovial cells. It has anti-inflammatory activity.
Pentoxifylline (brand name Trental) Pentoxifylline is a competitive nonselective phosphodiesterase inhibitor which raises intracellular cAMP, activates PKA, inhibits TNF and leukotriene synthesis, and reduces inflammation and innate immunity. In addition, pentoxifylline improves red blood cell deformability (known as a haemorrheologic effect), reduces blood viscosity and decreases the potential for platelet aggregation and thrombus formation. Pentoxifylline is also an antagonist at adenosine 2 receptors
This shows that there is a relationship between the mechanisms of Apremalist and Pentoxifyllin. They both are small molecule drugs that work intracellularly targeting the secondary messaging system INSIDE the cell. What Apremilast does is inhibit PDE4. When this happens cAMP stays active longer. When this happens pro inflammatory cytokines are down regulated and anti inflammatory cytokines are up regulated. TNF is also down regulated, but not nearly as effectively as with biologics. The comparisons are dramatic and I find more and more connections as I look into it (neutrophils affected for example).
Pentoxifyllin was tested for RA, which is different than PsA, and Apremalist is not labeled for RA. Perhaps Pentox has been overlooked in the shuffle of these drugs and has not been tested because it wouldn’t be as profitable. Who the heck knows? I DO believe that there could be a very subtle difference between these drugs that could make a huge difference in outcomes.
I could go on for a long time, but you get the point! 🙂
Please tell me – are you getting good results with this drug?January 7, 2016 at 8:47 pm #454565
And I forgot to point out a major difference between Pentox and Otezla. Otezla is selective for PDE4 and Pentox is nonselective so it affects all phosphodiesterases. That could definitely result in different outcomes.January 7, 2016 at 9:34 pm #454566PhilCParticipant
Have you ever researched Pentoxifylline?
Yes, I have researched pentoxifylline, and I will most likely do more research on it in the future. Sorry for the delayed reply. I didn’t see your message until today.
I’m glad that you posted about your experience with pentoxifylline. I’ve known about this drug for years, and had contemplated posting something about it. I guess I was waiting to see if more research on the use of pentoxifylline for the treatment of inflammatory diseases would be published.
Based on what I’ve read, pentoxifylline is a very safe drug. I believe that it is most likely safer than any of the DMARDs used to treat RA and other rheumatic diseases. Also, even though it is an inhibitor of TNF-alpha, unlike the biologics that inhibit TNF-alpha, pentoxifylline does not seem to increase the risk of serious infections (at the doses normally used). But that may be because pentoxifylline is not as potent an inhibitor of TNF-alpha.
This is a collection of abstracts on the use of pentoxifylline for the treatment of vasculitis that I compiled back in the summer:
When I did that research I was focused on vasculitis because I was trying to collect sufficient evidence to convince a family member to try pentoxifylline.
"Unthinking respect for authority is the greatest enemy of truth."
- Albert EinsteinJanuary 8, 2016 at 10:26 am #454573January 9, 2016 at 3:09 pm #454580
I did not realize Pentox. was a TNF inhibitor when I started it. In 2006 a year prior to my Psoriatic Arthritis attack, I discovered I had Peyronie’s plaque scar tissue that was causing problems with curvature. Other than taking some herbal supplements the situation stabilized after I started Minocycline in 2008, but I never made any connection between the two diseases. In September of last year the penal scar tissue started to cause problems again and I found that Pentoxifylline is one treatment used, from research on the Peyronie’s forum. Both Peyronie’s and Psoriatic arthritis are connective tissue diseases. I don’t believe in remission, but the Pentox. certainly has made my treatment program better in that I don’t have to use Prednisone or Nsaid’s any more.January 10, 2016 at 9:28 am #454589
Thank you for this update. To me this is amazing and one of the reasons I keep an eye on this board. I am going to look at the PDE’s other than PDE4 (which Otezla selectively targets) to see what roles they may play in inflammation. I will let you know what I find soon.
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