Chest infections

[Sherlock11]

Does any one with RA keep having chest infection with the bacteria pseudomonas . Are any of you on Biologics for your RA, and what have you been told by your Rheumatologist in respect of taking the Biologic? This is what I keep getting and I was just wondering what every one has been advised. I don't want to stop the meds as they are so effective. Thanks for your thoughts.

[julie1908]

Many years ago I was on methotrexate then metoject and i kept getting continuous infections like chest infections and cellulitis in my leg and had to stop taking it x

[AgedCrone]

Do you mean you keep getting chest infections now on DMards, & are wondering if taking a Biologic will make things worse?

I have had RA for nearly 30 years & I have never had a chest infection…& have been on a Biologic since 2016…& still no infection.

Maybe someone who did experience chest infections & is now on a Biologic can explain if they got more frequent!

[Sherlock11 in reply to AgedCrone]

I'm already on Biologics, and I have started having frequent chest infections with the pseudomonas bug which tends to affect immunosuppressed people and can be difficult to eradicate.

[Neonkittie17]

I had to stop/change my previous biologic due to recurrent chest infections (24 in 4 years .. basically every other month on fortnightly antibiotics. That was due to my biologic takingmyt igG down below threshold into hypogammaglobulinemia which can result in repeated infections including bronchitis. ) I have no experience of pseudonomas myself. Mine was repeated bronchitis and also pneumonia. I was more susceptible on my biologic.

[3LittleBirds2]

Hi, I get repeated UTI’s with Rituximab I always have but it works well for me or has done in the past, I did get a very nasty one with bacteria pseudomonas a couple of years ago. Also I developed a lung infection that is still there but dormant..caught it from my dog who had kennel cough, all whilst on Rituximab. I was taken of Ritux but not because of infections for a year, I’m now back on it. Unfortunately, it’s just a side effect to put up with it, and I’m sure if your Consultant thought the infections were becoming an issue you would be taken off it?

[Sherlock11 in reply to 3LittleBirds2]

Yes, that is the bug I have. I had a HRCT of my lung which showed an infection, although I have been treated several times with the correct antibiotics. It also showed I have a small amount of bronchiectasis as well. I really don't want to stop the biologics as they are very effective. I don't take methotrexate or any other DMARD except for sulphasalazine.

[3LittleBirds2 in reply to Sherlock11]

Very similar to you, I had a routine chest which showed a hazy shadow, then a HRCT which showed possible infection and bronchiectasis. I had to have a Bronchoscopy as I had no symptoms of an infection, which was then sent to the lab and the infection identified., No treatment needed as no symptoms but I will be monitored as well as for the bronchiectasis which is likely RA related. Until the infection cause was identified I had to stop RA Meds but now back on them, infections are a sad side effect of taking them..well for me anyway. 😔 I didn’t get any infections while on previous RA meds but I do seem more prone since I’ve been on Ritux.

[MistyDay in reply to Sherlock11]

It could be that taking sulphazalazine and a biological is lowering your immunity too much. I take benepali. On the leaflet it says caution with sulphazalazine. I used to take sulphazalazine before benepali but my rheumatologist weaned me off benepali in order to take benepali.

[Hisue]

Are you taking Mtx with a biologic? The Product Information (PI) insert provides info on Rx side effects.

Additionally, from "The Rheumatologist"(ACR-ARP publication): "Low-dose methotrexate (MTX; typically prescribed at doses of 10–25 mg/week) for systemic rheumatic diseases may induce relatively mild pulmonary adverse events (AEs), such as cough and dyspnea. However, a very small proportion of patients may experience severe pulmonary manifestations, such as pneumonitis...."

[Lolabridge]

I have had chest infections and bronchitis more often since being on various biologic RA drugs but I haven't been told that any have been from a Pseudomonas infection. I do try to avoid getting infections if I can, especially Covid, but I do want to see my grandchildren (unless they are obviously unwell) and they are the most likely source of any infection I may contract.

[MistyDay]

I have RA . From your profile, it appears you have a different autoimmunity, which I know little about, so it is less easy to support you here. Therefore I will tell you what I do , having RA. I stop taking biologicals if I have any infection until the infection has gone. Biologicals lower my ability to fight infection. Not being on them until the infection goes gives my immunity, with the help of an antibiotic, a better chance of recovery, and a better chance to fight the infection . I have RA which means part of my immune system is over active so my immune system is attacking myself. A biological suppresses this overactivity, and lowers my ability to fight infections.Once the infection goes , I take the biological again as it does wonders for my RA. If you keep getting infections make sure you have plenty of citric fruit, nuts and take vitamin to build up your immunity. I eat nutritious foods full of vitamins and minerals and do all I can to keep germ free.

[TheBoys]

If my lungs were so affected I would not be on MTX or biologics. Moreover my Rheumatologist wouldn’t let me - I used to have infections and they monitored me before going on MTX. I have spirometry tests annually and am advised that any chest infections - stop and RA drugs.

[Sherlock11 in reply to TheBoys]

I have only recently started having lung problems and I have been on DMARD's of some sort since 1999. I have been on Biologics for 5 years. It's difficult with my Biologic as I only have it 12 weekly and often I'm mid cycle when I have an infection. If it's near my injection I delay until I'm ok.

[TheBoys in reply to Sherlock11]

Ahh I see and understand.

I had a lot of problems culminating in pleurisy and sepsis a few years ago. It took nearly a year to get stable. So you really have my sympathy… I do hope you get through this.

[RAat13]

Wow, Pseudomonas is a tough infection to shift and a serious one at that!If you're taking your biologic whilst you have the infection you shouldn't be..

Pseudomonas is gram-negative and resistant to most antibiotics.

What have they given you? For how long?

It usually lingers for weeks so a longer course of antibiotics is needed!

[Numptybrain]

I’m different had issues with chest since childhood bronchitis then brittle asthma at 19 now bronchiastasis now Serositis which is inflaming my lungs badly with RA only recently discovered. I’ve had numerous infections pneumonia sepsis pseudos etc but my only hope now is RTX infusions as they can’t keep upping and lowering my prednisone and dmards arnt strong enough .

Take care

Wendy xx

[davannh]

when you have RA & a lung condition it will always be a choice between relieving your RA and keeping clear of infection. However having poorly controlled RA will also affect your lungs.

[Evie3]

I got repeated chest infections (not pseudomonus) whilst on Rituximab. I am changing meds now. However they were going to put me on a low dose antibiotic 3 times a week to keep the infection under control.

[MistyDay]

Having read further comments, I understand more clearly now. So sorry for the misunderstanding as I had not realised you have RA in addition to other conditions. I have no experience of infusions. So tough to work out what to do, when you also have a serious lung infection. I hope you get expert advice and support, and I send my deepest sympathy. Take care.

[Sherlock11 in reply to MistyDay]

That's ok, I have a lot going on.🙂