HealingWell
Search Close Search
☰

Question on biologics

Support Forums
>
Ulcerative Colitis
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 6/7/2015 10:15 PM (GMT 0)
I'm on prednisone 25mg per day. Of course I want to get off it, but when I reduce the dosage everything gets worse. (Mesalamine has not had any effect.)

The next step up the ladder is biologics - namely Humira. I've seen several doctors and they all say that. (There is of course 6mp, aza, etc, which have problems of their own.)

But they have a black box warning - may cause lymphoma. Make you susceptible to infections which can be fatal.

Question: Why do people on the forums here say that prednisone is way more "dangerous" than biologics? I've read extensively, and there are lawsuits, settlements, permanent nerve damage, even death from biologics.

Thanks
Posted 6/7/2015 10:41 PM (GMT 0)
the long term health effects of pred are almost gauranteed. those with serious biologic side effects are just a few percent.
Posted 6/7/2015 10:54 PM (GMT 0)
I agree - with pred side effects are almost guaranteed, with the other medications they are very rare.

I was recently in hospital and received an infusion of infliximab. Before hand I had a detailed discussion with my IBD nurse about the possible side effects. I asked about lymphoma - she had not seen a single case in her whole career and we are talking about hundreds and hundreds of patients being treated with this medication over more than a decade. I'm trying to trivialise it or say that it does not happen, its just very rare - an acceptable risk.
Posted 6/7/2015 11:07 PM (GMT 0)
It's because prednisone is worse in many ways because it has a much higher risk of side effects that can be either temporary or permanent. The risks with Humira (especially the chance of lymphoma are so slim in comparison to Humira. Plus they monitor your blood work very closely while on biologics, they don't with prednisone.

Humira is the first med that actually put my CD into remission after flaring for 23 years straight, pred was a band-aid med that wore off within the first couple of weeks (as it does for most) and I had racing mind and issues sleeping even though I took pred first thing in the am, by the time I went on it for the 5th time it did absolutely nothing to help it only caused weight gain, those are the only side effects I ever had with my prednisone experiences. With Humira I started getting bad headaches (I'm on it weekly not biweekly) but found that taking an antihistamine the before bed each time I do my injection I no longer get the headaches and I don't get any other side effects from it either.

I guess when you've been sick everyday for over 2 decades and finally a med comes along and clears up all your inflammation (including a recto-vaginal fistula which was devastating to deal with in itself) you become grateful very quickly and appreciative for something that actually works....the risks of being inflamed constantly far outweigh the risk of Humira IMO.
Posted 6/7/2015 11:40 PM (GMT 0)
I've been on remicade since 2009 without any side effects. I'm now on an anti-hypertensive because of prednisone...my blood pressure was 170/100 while on it this past Jan-March. The same thing last winter as well. I always respond well to it but there is a price to pay.
Posted 6/7/2015 11:45 PM (GMT 0)
It all comes down to risks versus benefits. The odds biologics will improve your uc symptoms are 60 plus percent. The most concerning side effect of these medications is lymphoma which has odds of 6 in 10,000 (or 0.06 percent) compared to 2 in 10,000 ( or 0.02 percent) for the general population. The odds of death due to heart complications is 1 in 5, of death in a car crash are 1 in 133, so we're talking really small odds for biologics. The The Crohn's and Colitis Foundation of America is the source for these statistics:
Webcast: programs.rmei.com/CCFA139VL/presentation/player.html
Transcript: www.ccfa.org/assets/pdfs/risk-and-benefits-transcript.pdf
Posted 6/8/2015 12:30 AM (GMT 0)
Prednisone can be a great short term drug but using it as a long term treatment has about a 100% chance of doing all kinds of nasty things to your body, not to mention making you want to kill the mailman. I think really bad side effects of the biologics come in at around 2%, although there is a higher percentage of nuisance side effects.
Posted 6/8/2015 7:30 AM (GMT 0)
My rheumatologist said that in his experience the increased risk of lymphoma seems to be most common in people who are older when they start biologics (over 60). He said he's not sure why and of course it is early days in the use of biologics, but he's not sure the increased risk is spread evenly across all users.

Have UC, one question I have is why the next step for you are biologics before you try azathioprine? It's a more common next step than biologics for a number of reasons, including cost and ease.
Posted 6/8/2015 12:29 PM (GMT 0)
It takes drugs like azothiapran a long time to kick in
If you are flaring they will want to go straight to biologics as both the long and short term affects of flaring are more dangerous than the drugs they use to control them
However it is a good idea to use 6mps along with biologics to prevent them from being "rejected" and to be affective for as long as possible
Posted 6/8/2015 12:45 PM (GMT 0)

DBwithUC said...
the long term health effects of pred are almost gauranteed. those with serious biologic side effects are just a few percent.

In a nutshell this. It also tends to be elderly people with multiple health conditions who get serious infections from the biologics. (And 90% of the exeptions to the rule find their way towards HW.)

But the long-term side-effects of Pred are 100% guaranteed, no matter your age or health status. The only requirement is being on Pred for long enough to get them. For some people it'll take weeks, others months or years. But it will happen.
✚ New Topic ✚ Reply