One of the common and big fears patients with autoimmune arthritis have when they are prescribed biological medications is that they think they will be susceptible to any type of infection at any time in any place or organ in their body. For patients who think that way, we would like to tell them this is not really true. They need to know two very important facts here.
The immune system in your body is a big army; in fact, it’s a huge army. Any army has many different types of weapons. Those are the weapons of an army. And those are the weapons of the immune system. Instead of a knife and gun and bomb, our weapons here are TNF, IL-6, IL-1, CD20 and JAK and so on.
Any biological medication that we prescribe to a patient suffering of an autoimmune arthritis, this medication will be targeting and inhibiting or down regulating a specific weapon in the immune system like TNF or IL-6 and so on. We choose the medication that targets the specific immune weapon that, by mistake, got over activated in that person and caused that specific autoimmune disease that we treating now. Remember that in every autoimmune disorder, there is a set of very specific immune weapons that get overactive. It is not every weapon of the immune system. It is specific weapons.
Since every weapon in the immune system provides defense and immunity against specific types of microbes that we know by name, this means that if we target and inhibit a certain immune weapon by a biological medication, then this means that we know what kind of specific microbes the patient might be more susceptible to if he uses that medication.
In that case, we can take the needed measures that include specific tests and specific vaccines before we start treatment with that medicine, and that also include what kind of symptoms and signs related to any possible infections that we need to keep an eye on during the follow up of the patient. So, the concept that I might get any type of infection at any time is not a correct one.
The second piece of information you need to know here is that in general the doses of biological medications that we prescribe are set based on several variables and one of those variables is that we use the dose that does not make you too much susceptible to microbial infections. For example, suppose you are prescribed a certain biological medication at a given dose. Using this dose will improve your symptoms over 6 weeks by 50 percent without being really overly susceptible to infections. At the same time, if you use that biological medication at double that dose, your symptoms will likely improve in only 2 weeks by 80 percent but you will be quite susceptible to infections. In that case, the practice of medicine will surely go for option A; the slower but safer improvement of your symptoms. This is how it works.
So, the conclusion of this Article: if I am using a biological medication, am I susceptible to an infection? The answer is yes. But to what kind of infection and to what extent you will be susceptible to infection, you need to consider the information revealed in this Article.
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This post was prepared and published by Dr. Hatem Eleishi. Dr. Hatem Eleishi is a professor of rheumatology at Cairo university (Egypt) and is especially dedicated to supporting arthritis patients with online educational videos and articles about arthritis causes and treatment. He also runs a rheumatology clinic in Cairo and a center for www.tabibakom.com/en that, in addition to providing online rheumatology consultations, also provides online medical consultations in several different medical specialties by expert consultants from Egypt, Canada and the United States.
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