How much immune suppression with biologics? - NRAS


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How much immune suppression with biologics?


I've resisted biologics as I have Lyme as well as RA--Anyone know just how much these biologics suppress your immune system? We need some gas in the tank to fight the various viruses that will continue to be around, right?

I can quite understand why we shouldn't enhance nitbweaken our immune systems. Thanks for thoughts. Wyaatch--Sandy

10 Replies

I found a Cochrane study on this (which are studies that analyse lots of other research studies so they are more reliable) which covered the nine most commonly used biologics. The most important thing is that a weakened immune system runs the risks of any infection turning serious.

The study concluded that

"Among people who took any biologic, 35 people out of 1000 experienced serious infections compared with 26 people out of 1000 who took placebo"

So for those 35 people it's awful, but in terms of your overall risk it's not hugely much worse. Hope this helps you make your decision.

Wyaatch in reply to helixhelix

Thank you so much for taking time to answer me--that study looks fairly reassuring--I know we're all different but it helps to know the facts.

As Helix says for most of us there is no increase in infections....important that you do all you can to stay healthy of well, exercise etc!!

For me the biologic group give me less side effects than the DMARD group. My current biologic Abatacept does take my WBC and neuts low so I have to be aware of what is going on in my body and take appropriate action when necessary. I have been using Abatacept for 3 years and only a couple of minor issues when colds have been doing the rounds but nothing serious or worse than other biologics I have used. Farm

I've been on various biologics for nearly 3 years and only once in that time did my doctor tell me to be aware as my immune system was quite low. In that nearly three years, I've had bronchitis once and a cold only twice. I don't think that's bad at alll. Clemmie

AgedCrone in reply to Barrister

I agree with you Clemmie..I went through Dmards & now on RTX since April 2016, & I honestly had more colds before I took any RA drugs.

it seems chest infections seem to be mentioned when this subject arises....I wonder did people who get these have them before taking Dmards/Biologics, & they would have had them anyway, RA drugs or not?

Just a thought!

Unfortunately, I have developed hypogammaglobulaemia I.e. low immunoglobulin levels due to 10 years on Rituximab and 30+ years on methotrexate and steroids. Now require a series of 3 immunoglobulin infusions about every six months to maintain my immune system.

I would encourage everyone to monitor their own IGg levels if you suffer repeated infections. After several years of suffering many UTIs and chest infections and when I got shingles for the fourth time I did my own research and saw my Rheumatologist last year to tell him of my suspicions. When he checked my IGg levels they had been low since 2012 and this had been missed. He tells me he has 3 other patients with the same problem requiring treatment.

This is not meant to frighten anyone. I most certainly cannot function without my Rituximab. It has dramatically improved my quality of life and I have no regrets about having the treatment. However, I just want to emphasise the importance of managing one's own condition. Best wishes all.


louise-a in reply to Pam-51

May I ask if the infusions have stopped the shingle attacks or just the infcetions ?

Since starting the infusions last November have only had one shingles attack and a couple of chest infections so much improved. Now have the anti-virals at the ready in case the shingles recurs and can self medicate. Thanks for asking.

Best wishes Pam

Hi all. I've been on Rituximab since 2009, and I've had no serious infections. A few colds that perhaps took a little longer to shift. I hate taking ANY drugs, but this works pretty well for me, and so I take it. Nevertheless, I do worry about side effects we are maybe not really aware of. Ho hum. Swings and roundabouts.

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