Biologics and Infection | Arthritis Information
Has anyone here developed a lung infection after starting on biologics? I
mean, a serious infection like pneumonia or tuberculosis? I've heard
some people on biologics have had lung-related issues, but would be keen
to hear if anyone here has experienced this.
I had to see a pulmonologist this week because I developed pleural effusions while in the hospital a few weeks ago with a kidney infection.
Turns out my problem was not serious and should resolve itself on its own. But I did talk with the doctor about the biologics and meds I've been on since being diagnosed with RA. I told him I had been on methotrexate, Humira, Embrel, Remicade and Rituxin, but nothing had worked for me, except prednisone.
He said that might be a blessing in disguise because he has seen some very nasty lung infections from the biologics, especially Rituxin (which I just had a few months ago), I believe. He didn't say much, but he seemed very disapproving. I should have asked more, but I was a little shocked.
Kinda scary, I know. I was scheduled to start Orencia before I got sick, now I don't know. I've always known the meds have some serious side effects, but thought the results might be worth it. And for many people it still might be.
Thanks Sula, that's interesting. We both have Humira in common. I'm reluctant to
knock it, because after starting it a few months ago, I was doing great. Now I
have either plural effusion or something else lung-related, and i was interested
when my rd said humira might be responsible. next step is a lung biopsy
under general anaesthetic. antibiotics/steroids haven't worked on the infection.
and i've had to stop the humira. talk about a rock and a hard place!
I've been on Rituxan for over a year and not had any problems. I also have used Enbrel and Humira and I didn't have any problems with them either....I think I've been on some type of biologic since 2002, first remicade, then humira, and now enbrel (w/mtx). During that time, I've been fairly fortunate and not been sick. Sinusitis has been a problem for me, never that severe to require antibiotics, just enough a problem to be annoying. It can be related to taking biologics, though I had sinusitis problems prior to starting biologics.
I do have a flu shot every year, and now, am tested for TB yearly.
Joie2008-07-25 09:31:30
[QUOTE=Joie]I think I've been on some type of biologic since 2002, first remicade, then humira, and now enbrel (w/mtx). During that time, I've been fairly fortunate and not been sick. Sinusitis has been a problem for me, never that severe to require antibiotics, just enough a problem to be annoying. It can be related to taking biologics, though I had sinusitis problems prior to starting biologics.
Jas,
Thanks for the tip Jas, I will definitely give a "neti-pot" a dry.
(Ooops, not a "dry" but a "try", guess its time for a "trink."
Joie2008-07-25 09:47:20I have Broncheictasis, and have done since I can remember, and started Humira last June 2007 after both RA doc and Chest Doc decided it would be ok for me. Last April I came down with a very bad lung infection, I had pain in my left side that was unusual for me and was coughing up blood, I did go to see my GP 3 times doing that time but she didn't pick it up. It wasn't until my bloods came back and levels were very high, that they knew something wasn't right. I was hospitalized for 3 weeks, had to have a lung drain (Empyema) which I never want to go through again. The doc took me off Humira straight away and after questioning, he did tell me that I probably would have gotten the infection whether on or off the Humira. I am now on Orencia after going through so much pain while off the Humira, I must admit I thought I could manage without biologics, but when the pain resurfaces, you know you can't.
My Doctors work very close together, and I try to do everything to keep infection free, exercise, good diet, raw garlic, olive leaf, and spiralina. Hope this helps and not put you off trying biologics.
Sorry Appletown......didn't read your second post....I too did very well on Humira.....strong antibiotics didn't work for me either, thats why they decided to do the drain. Hope it all goes well for you, and I will be saying a prayer for you too. But don't give up on the Orencia, I have been told it works a bit different than the others, and less likely to cause infections.i've been on all of the biologics with no infection problemsThanks for that info Rockin Annie. It's soo true that when you don't have pain you think you would be able to handle it again. i was on humira about the same period as you and it was amazing. but having developed this lung infection i've had to go off humira and it's been a wake-up call to see how quickly the old symptoms and pain returned (i've had a left wrist fusion, amongst other ops; now the right hand is going south). ultimately, the choice now is between not being able to breathe properly and being pain-free, or breathing properly and putting up with the pain. i'll certainly discuss Orencia with my rheumatologist as an alternative. thanks again
Gee, My RD suggested having my wrists fused, but I am terrified of having that done, He did say to me at the time, the only problem you would have is (while grinning at me) was going to the toilet, well I didn't think that was funny at all, I could'nt think of anything worse. How do you manage with your fused wrist and how does it look, I am a dancer, would it affect me dancing?. I am seriously thinking about the AP treatment if the orencia doesn't work, I still worry sick about chest infections. I have lived with my broncheictasis forever and no drama since going on biologics.......I hope you are feeling ok now!
annie
a good hand surgeon will angle one of the fused wrists to allow for personal hygeine. oNce fused the wrists would no longer move up and down. You'll be able to rotate them though. The good news is that the wrist pain will go away and it will stabalize allowing you to lift things you can't right now. It may feel a bit strange at first but you rapidly get used to the lack of movement
Remember that no treatment is going to fix the existing damage
I was on Enbrel, that didn't work, changed to Humira, been on a biologic for about 8 months I guess. The only problem I've had is picking viral stuff, the kind that makes you vomit and have diarrhea. I get it every few months. I am really surprised I don't get sick more often than I do because I'm around sick people all the time in the ER.I had a serious case of bronchitis while on MTX & Humira a few years ago. They thought it was phnemonia; but xrays ruled it out. Just bronchitis....and it took close to a month for me to get well. That was the sickest I've ever been. I was off all my meds and was just on antibiotics and predisone for more than a month. Between the illnes and being off my meds it was pure hell. Other than that I haven't had any other problems. I've been very lucky. Other than RA I've been extemely healthy. (knock on wood)
Hope you're feeling better soon and it doesn't turn out to be anything too serious.
Dear Rockin Annie
There's only one decision guiding you on whether or not to have a wrist fusion:
pain. I reached a threshhold of pain where I really couldn't handle it any more.
I welcomed the possibility of ending that pain. Sooo, they put in a titanium plate with screws and fused. A year down the line I'm very happy with the result. No pain.
OK, slightly limited mobility, but you can do all the things you need to with your
new hand. Post op is a little sore, but believe me, it's worth it. I sometimes "clunk"
my hand by inadvertantly colliding with an inanimate object but i can type and pick
up a beer and almost arm wrestle! My right hand is going same way, but yu really don't have to worry about personal necessities etc. you do manage OK and your surgeon will
do the fusion to optimise the use of your hand... Hope this helps!
thanks for that lovie
very similar experience here. antibiotics and cortizone for a month
did nothing. now they want to do a lung biopsy.i really don;t know if
that's the right decision. and being off the humira has called in the
wrecking crew. and they're doin a damn good job. r/a is like a bush fire:
you put out a fire over there, and another one breaks out over here...
Thanks Buckeye and Appletown for your replies. The RD did tell me he would angle one wrist, but I guess I was horrified at having any surgery at the time. but after finding this forum its making a lot of things clearer for me, I guess I kept thinking as we all did, that I was going to get better, I now, know that I am not. So I will concentrate on sticking with the Orencia, then AP therapy then I guess last resort is surgery. Thanks again guys.Dear Annie
Going in to hospital tomorrow
will let you know
Good luck AP, and plenty of thoughts go with you.
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