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On golimumab for psoriatic arthritis. High gamma GT reading and high BP. What is causing this?

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Allergist and Immunologist
Practicing since : 1999
Answered : 584 Questions
I am on golimumab for psoriatic Arthritis and I'm also taking 10mg of Prednisilone daily. I have my bloods taken fairly regularly and the last couple of results show a high Gamma GT reading, 289 and 287 (two months apart) My blood pressure has also increased from a normal of 90/70 (aprox) to 138/88. I have only been taking the golimumab for 4 months and really want to continue to give it a chance to work on my condition. Is there any chance the steroids could be causing these results?

Many thanks,
Posted Mon, 17 Dec 2012 in Arthritis
Answered by Dr. Sujoy Khan 3 hours later

Thank you for writing to us.
As you know, Golimumab is a humanized anti-TNF agent and approved for psoriatic arthritis.
It also helps in lowering the dose of steroids.

Phase II and III trials had shown that golimumab leads to a mild increase in ALT and AST and very high levels (>5 times upper limit) was rare. The raised GGT in your case may mean something similar but it is not very high (you should check what the upper limit of normal GGT is from the lab). You have not mentioned the AST and ALT levels. If those, along with alkaline phosphatase, white cell count, CRP is normal or just mildly raised, then the GGT is not very significant. Also GGT is quite sensitive, hence most Rheumatologists would check the AST and ALT levels.

You are right in saying that steroids may be affecting the GGT and the blood pressure. Your previous BP was quite low and the new one is more acceptable, although I get your point. You should check with your doctor on the possibility of changing over to Deflazacort from Prednisolone as it has much lower side effects.

You must give the Golimumab a chance and please do not hesitate to ask if you have any more queries.
Best Wishes.
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