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How much more immunocompromised will I be with a biologic?

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1Wish
Regular Member
Joined : Mar 2018
Posts : 287
Posted 1/12/2022 10:18 AM (GMT -8)
Hi, I've been on Imuran and Mesalazine now for 3 years and its appears due to daily bleeding everyday for over a year, it's time to step up to biologics, even though only going 1-3 times a day, some days none at all. I've also been on rectal meds for over a year from retention to foam to suppositories. Both mesalazine and budesonide.

My appointment with the GI is on the 20th to discuss this and I'm getting worried the closer its getting regarding side effects and risks.

I would like to know how much more immunocompromised I would be with something like Remicade or Humira vs Imuran? I say those 2 biologics because they will likely be the options in Spain first. Is there any specific comparison data on this?

1Wish
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poopydoop
Veteran Member
Joined : Dec 2018
Posts : 2002
Posted 1/12/2022 10:29 AM (GMT -8)
I don't think you will be more immunocompromised on a biologic than imuran. They affect the immune system in different ways. You were probably put on imuran first because it was cheaper, not because it was safer.
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straydog
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Joined : Feb 2003
Posts : 19629
Posted 1/12/2022 11:08 AM (GMT -8)
1Wish, when I was on Remicade & later Humira, I was also on Imuran. I never got sick because of the medications. While on Remicade I had to go to a small town hospital & was exposed to plenty of sick people & never caught as much as a cold. Back then, you never saw admitting wiping anything down, I sat away from other patients & people until I was taken to the room for my infusion.

With Covid all medical facilities are taking a lot of precautions to protect patient. Good luck on your appt.
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1Wish
Regular Member
Joined : Mar 2018
Posts : 287
Posted 1/12/2022 11:51 AM (GMT -8)
@poopydoop, thats likely the case in Spain yeah. I just always thought a biologic is stronger or a bigger risk for bacteria and fungus etc than Imuran. Wheres Imuran Ive been told my a doc is worse for viruses such as Covid.

@straydog, thats certainly reassuring thank you. I know a person on biologics who is generally fine. I believe only once she had an infection in her foot that got quite bad but antibiotics knocked that out.

Pressure on other organs like the liver does worry me a bit, again, not sure how much more than Imuran it is, but the thought of something like Remicade taking hours via infusion makes it looks like a massive deal for the body!
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island time
Veteran Member
Joined : Dec 2014
Posts : 2375
Posted 1/13/2022 4:32 AM (GMT -8)
I’ve been on Humira since April (or late March?). Came down with a bit of pneumonia during the loading doses. Latest models from U of F (Tampa) is showing 80% of Floridians will have had some type of covid by the time omicron wave is over (their models have been spot on for 2 years). Their updated omicron model shows a peak this week. Then should “fall off” as quickly as it began, to be gone by late January or February.

I believe Humira has actually helped me from becoming infected. But, I am careful so there’s that…
——
On Humira
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1Wish
Regular Member
Joined : Mar 2018
Posts : 287
Posted 1/13/2022 6:15 AM (GMT -8)
Hey island time, the initial dose caused pneumonia or you’re immune system was lower and caught it from somebody?

Why do you say Humira stopped you from getting covid? You mean from developing serious inflammation if caught?

Is the loading dose higher then reduced?
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CCinPA
Veteran Member
Joined : Dec 2014
Posts : 2743
Posted 1/13/2022 8:29 AM (GMT -8)
I am just more careful and so far (knock wood) I haven't been more sick than before biologics. If anything, pre-covid when I was around others all the time, I was less sick. I think it's because I hand sanitize after I touch anything (door knobs, elevator buttons etc). I did that long before Covid.
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Sara14
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Joined : Mar 2007
Posts : 7914
Posted 1/13/2022 2:50 PM (GMT -8)
I haven't noticed any difference myself. I haven't even had a cold since before covid.
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island time
Veteran Member
Joined : Dec 2014
Posts : 2375
Posted 1/13/2022 3:23 PM (GMT -8)

1Wish said...
Hey island time, the initial dose caused pneumonia or you’re immune system was lower and caught it from somebody?

Why do you say Humira stopped you from getting covid? You mean from developing serious inflammation if caught?

Is the loading dose higher then reduced?

“In conclusion, our study indicated that TNF-α blockers, including infliximab, adalimumab, and etanercept, not only overcame inflammatory reactions but also decreased odds of COVID-19 incidence in patients with autoimmune disorders . Moreover, TNF-α blockers might help to prevent the cytokine storm caused by SARS-CoV-2 infection and consequently decreased the severity of COVID-19 and the need for hospitalization. Therefore, the use of TNF-α blockers probably had a direct and positive correlation with the decreased COVID-19 incidence, suggesting the prophylactic role of these drugs in preventing COVID-19 in autoimmune patients suffering from RA and SpA.”

https://link.springer.com/article/10.1007/s40744-021-00342-8

1Wish….

I cannot say that the loading doses of Humira caused my pneumonia. I may very well have gotten it without taking any Humira at all. As with a lot of what we are all dealing with right now…It might very well have been coincidental. It was not something that came close to hospitalizing me. I just had an upper respiratory infection…went to the doctor, he listened to my lungs and said, “you may have a bit of pneumonia.” Whatever it was, it wasn’t something so serious that he even felt it warranted a chest x-ray. One wasn’t done. It’s very possible it wasn’t even pneumonia. This was just one doctor’s quip after listening to my breathing through a stethoscope. He sent me home with some antibiotics and a week later I was on the mend.

Part of why I believe Humira has helped me to stay healthy is just anecdotal. I live in one of the hottest spots in the nation for covid. I also live on a boat. So, every time I need to go to the store or run an errand in my car, I have to walk a fairly good distance to my car. There’s always a lot of people on these docks. It’s just impossible to completely social distance anytime I leave the boat. I always mask up and rarely spend anytime time talking to them. Knock on wood, something is keeping me from getting it. As far as the Humira goes, I have had no other infections or illnesses since being on it. So far, so good.

Post Edited (island time) : 1/13/2022 4:51:49 PM (GMT-7)

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Faithmac
Veteran Member
Joined : Apr 2008
Posts : 1639
Posted 1/17/2022 5:15 AM (GMT -8)
I haven’t really noticed any difference. Been on biologics for sometime. Four of them as of now. They all worked . I’m lucky! Never really had a cold. Everyone is different
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Faithmac
Veteran Member
Joined : Apr 2008
Posts : 1639
Posted 1/17/2022 5:17 AM (GMT -8)
I haven’t really noticed any difference. Been on biologics for sometime. Four of them as of now. They all worked . I’m lucky! Never really had a cold. Everyone is different
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UCyousee
Regular Member
Joined : Feb 2014
Posts : 480
Posted 1/17/2022 7:03 AM (GMT -8)
Like other posters I haven't noticed biologics (Humira then Stelara) causing me to be immunosuppressed; I haven't been more sick than usual, either in frequency or severity, and I've had Covid twice (once while on Humira, once while on Stelara). (EDIT - ha! that might sound like a contradiction to those of you that haven't had Covid at all, but the two bouts were almost 2 years apart, and I know a lot of people vaccinated and unvaccinated that have had two bouts of Covid - omicron and an earlier strain).

I did think that I was immunosuppressed while on Azathioprine then 6MP though (and had side effects, as well as them not working) so I'd agree with other posters that moving to biologics doesn't necessarily mean more immunosuppression and more side effects.

As I understand it biologics are relatively specific in the pathway / mechanism of the immune system that they suppress.

Post Edited (UCyousee) : 1/17/2022 8:06:04 AM (GMT-7)

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