Hi, we're gonna talk about risks and benefits
of biologic medications.
If you have an inflammatory arthritis
like psoriatic arthritis, rheumatoid arthritis,
or ankylosing spondylitis,
you may at some point in your treatment
be offered a biologic medication.
These are medications such as TNF inhibitors,
which would include Enbrel, Humira,
Simponi, Simponi Aria,
Remicade, Cimzia,
or a T-cell modulator, like the drug Orencia,
or a B cell depletor, like the drug Rituximab,
or an IL-6 inhibitor, Actemera.
Now, you all have heard TV commercials
which are giving you some risks of these medications
and I think that what I would like to do
is help you understand, or put into context,
what those TV commercials are really saying.
So the one question I get most frequently
is does this drug cause cancer?
Well the answer is probably not.
What we know is that people with an inflammatory arthritis
are more at risk for infection and for
lymphomas than the normal population.
So for example, if you had a stadium,
let's say it's in a high school football stadium,
where there are 10,000 people
and none of those people had any type of a,
an inflammatory arthritis,
there may be about two people in that group of 10,000
who would get lymphoma.
Now if you took that same stadium
and you filled that 10,000 seat stadium
with people who did have inflammatory arthritis,
maybe four people would get a lymphoma.
Now, if all 10,000 people were also on
a medication like a TNF inhibitor,
then maybe four people would get a lymphoma.
So the risk doesn't go up with the treatment, really.
And what we might start to see in some of the data
is that the risk of lymphoma actually goes down.
I think that,
hopefully that will help you make a more informed decision
whether this would be the right treatment for you or not.
There's also risks associated with not having any treatment
and the risk with that is that right now
you are as good as you're gonna get.
So the question is, do you wanna stay that well
and continue to decline,
or do you hopefully wanna get back to
the function that you once had.
Those are things as well
that you really will need to discuss.
Another issue is to look at the risks of the medications
that are, that you're currently taking,
that do have significant risks
and side effects associated with them.
And the main culprit being Prednisone.
Prednisone has a lot of horrendous side effects
including things like hypertension,
high blood sugar, glaucoma,
delayed healing, diabetes,
so you really wanna weight the risks of
all of your different treatment options
and discuss with your provider
which is gonna work the best for you.