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Posted 5/22/2021 9:24 AM (GMT 0)
Good morning all.

Im 33 and have ulcerative colitis, currently on azathioprine, mesalazine and just got off a pred taper due to a flare.

For the past month Ive been getting stiffness in my index finger on my right hand, then couple of weeks ago started getting the same on the index finger of my left hand, now its on the finger next to the index on my hands.

As soon as I wake up, my fingers feel so stiff, I have to form a fist in each hand repeatedly to ease it a little but even then the stiffness stays all day, especially in the index fingers.

Has anybody experienced this or have any idea what it might be?

Feel like I have artritis but ***..Im 33…

Thanks,
1Wish
Posted 5/22/2021 12:11 PM (GMT 0)
I did have a lot of joint paints (wrists, fingers, sacroiliitis mainly) in my first 10 / 11 years of UC before Humira, but although the sacroiliitis was visible on MRI I've had no progression with the wrist and finger pain over 17 years of UC, and was checked out by a rheumatologist years ago, so I'd say that was arthralgia.

I didn't have arthralgia while I was on Humira for 6 years, which was an added bonus, but I've just switched to Xeljanz (tofacitinib) so I'm wondering whether the problems will return.

I think you'll only know for sure if you have arthralgia or arthritis with tests, seeing a rheumatologist, and possibly time (to see if there's any progression).
Posted 5/22/2021 12:11 PM (GMT 0)
I had this in my feet/ankles post prednisone. It was worse when I woke up or had been seated for a long time and it hurt to walk for the first 15 minutes of every day. I think it had something to do with coming off pred, but after 2-3 months it went away. I had been on pred from November -April so I was on it a long time.
Posted 5/22/2021 12:15 PM (GMT 0)
Are your fingers still straight or are they curling inwards? I know a couple of people (who don't have UC) that have 'Dupuytren's contracture' which is due to tendons thickening and tightening which draws the fingers in towards the palm.
Posted 5/22/2021 2:11 PM (GMT 0)
Another possibility is "trigger finger" which my husband had in three of his fingers (two on one hand, one on the other). He does not have UC. He ultimately had surgery to relieve it.
Posted 5/22/2021 2:30 PM (GMT 0)
Hi, thanks for the replies.

@UCyousee
I have made an appointment with a rheumatologist, I guess they will want to get an MRI, lets see. Humira is actually on the table due to my colitis, the only reason we are holding off is due to covid and not being vaccinated yet as it can both be a higher risk and less antibodies created because I was told likely I would have to continue on Imuran a year meanwhile too.
I will look into arthralgia although these days I tend to do a little too much of Dr Google. That said, I have gotten more info on my issues from the internet and especially this forum than my doctors..

My fingers are still straight, well, with the normal natural curve on all fingers.


@momto2boys
That would be great if it was just the Pred. This was a relatively fast taper from 30mg, completed in about 1 and half months. I was previously on prednisone twice for almost 6 months and never had this issue though.

@Serenity Now
From what I've read online, that's when the fingers get stuck bent? Thats not happened, its actually more difficult to bend the index fingers especially as if to form a fist.

1Wish.
Posted 5/22/2021 3:25 PM (GMT 0)
I can see the risk that Humira might lead to a reduced response to the vaccine ie fewer antibodies, but isn't the risk the same with azathioprine?

I think it's probable that Humira provides some protection against a cytokine storm from Covid infection.
There were a lot of studies into using anti-TNFs such as Adalimumab as a Covid treatment for people in hospital.

https://www.drugtargetreview.com/article/74674/treating-cytokine-storms-in-covid-19-patients/

https://www.thelancet.com/journals/lanrhe/article/piis2665-9913(20)30309-x/fulltext

I'm just curious as to why your gastro would think azathioprine is lower risk than Humira regarding Covid. Personally my immune system was suppressed by Aza far more than it was by Humira.
Posted 5/22/2021 4:02 PM (GMT 0)
My husband had the same problem with forming his fingers into a fist, more so than "getting stuck". So I think it can present in different ways. But of course, that is not to say that is what you have at all. Mostly I remember how painful it eventually got for him to move those affected fingers at all. He would even wake up from the pain in the middle of the night if he moved his fingers during sleep. So it sounds like it is different from what you have. Just a possibility to keep in mind, maybe.
Posted 5/22/2021 4:08 PM (GMT 0)

UCyousee said...
I can see the risk that Humira might lead to a reduced response to the vaccine ie fewer antibodies, but isn't the risk the same with azathioprine?

I think it's probable that Humira provides some protection against a cytokine storm from Covid infection.
There were a lot of studies into using anti-TNFs such as Adalimumab as a Covid treatment for people in hospital.

https://www.drugtargetreview.com/article/74674/treating-cytokine-storms-in-covid-19-patients/

https://www.thelancet.com/journals/lanrhe/article/piis2665-9913(20)30309-x/fulltext

I'm just curious as to why your gastro would think azathioprine is lower risk than Humira regarding Covid. Personally my immune system was suppressed by Aza far more than it was by Humira.

Its not that my GI thinks that. Ive been on Azathioprine for 2 years and she would prefer Humira due to covid as docs prefer it now because aza is more susceptible to viruses.

The issue is that in order for it to work apparently. I would need to be on Humira AND Azathioprine for a year in order to not create antibodies.

And that means double suppression..
Posted 5/22/2021 4:10 PM (GMT 0)

Serenity Now said...
My husband had the same problem with forming his fingers into a fist, more so than "getting stuck". So I think it can present in different ways. But of course, that is not to say that is what you have at all. Mostly I remember how painful it eventually got for him to move those affected fingers at all. He would even wake up from the pain in the middle of the night if he moved his fingers during sleep. So it sounds like it is different from what you have. Just a possibility to keep in mind, maybe.

Wow I hope it doesn’t get to that. The fingers are a lot more stiff upon waking thats for sure.
Posted 5/22/2021 5:48 PM (GMT 0)
I think I either posed this ? or answered it after I saw the doc, but my GI and my Derm strongly suspect I now have psoriatic arthritis. It is not uncommon to have aches and pains during a flare, my back always hurts, but I am wrapping up a MASSIVE flare and I am def having significant pain and stiffness in hands, fingers, knees, ankles and back. July 22 to see a Rheum!!! Crazy. But I have the sausage fingers and toes, where I used to have tiny adorable 5.5 size feet.

I am on Xeljanz which has handled the flare, finally, but does not seem to be helping with the suspected PA, which it should. Week 7. Good luck!

p
Posted 5/22/2021 7:11 PM (GMT 0)

1Wish said...
The issue is that in order for it to work apparently. I would need to be on Humira AND Azathioprine for a year in order to not create antibodies.

And that means double suppression..

Sorry - I'm still a bit puzzled by this. I completely came off Aza then 6MP (due to side effects and them not working) and switched to Humira with no overlap. I was on it for 6 years without developing antibodies to the Humira.

Everyone is different of course, but I've not heard of having to stay on Aza for a year while switching to Humira before. Is this something that's common?

Post Edited (UCyousee) : 5/22/2021 1:14:09 PM (GMT-6)

Posted 5/23/2021 8:01 PM (GMT 0)
I had severe arthritis during my last flare where my knees hurt to point where it was difficult to climb stairs. Interestingly I could not make a fist either but one day it would be my right hand but the next day the right hand is OK but my left hand would be stiff. However my arthritis disappeared once I got back into remission.

You might have a different problem. My girlfriend had a similar problem of not being able to contract some fingers in her hand. I dunno, perhaps it was Dupuytren's contracture. But she took some of the active form of vitamin B6, pyridoxal 5'-phosphate (P5P), and her stiffness was gone in 3 days.

http://www.ncbi.nlm.nih.gov/pmc/articles/pmc347366/?report=abstract
For all patients receiving therapy with pyridoxine, the B-6 deficiency was corrected and the neurological syndrome was alleviated...
"Rheumatic" conditions associated with this syndrome have included "tennis elbow," Dupuytren contracture, deQuervain disease, "trigger fingers," bursitis, and periarthritis of the shoulder.
Posted 5/26/2021 8:25 AM (GMT 0)
Hi @UCyousee.

From what I understood, since I am still bleeding and considered a flare. For them to approve Humira, I would have to be on Aza for a year at the same time. Just how the system works here in Spain I guess. The GI did also mention the part about being on Aza meanwhile also helps the body to not develop antibodies to Humira.

1Wish
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