Biologics and Immune System

Hi All,

I'm trying to understand the way biologics work and how they effect your immune system.

My theory is if you are taking biologics, which suppress the immune system, mainly white blood cells, how does one know if you are sick?

Say you have an ear infection, if the white blood cells are suppressed, the white blood cells which attack the infection will not be raised. You won't have a fever and the infection will get worse.

Now, this has actually happened to me but I want to understand. I felt a little pain in my ear a few weeks ago, did not have a fever. I didn't have any other symptoms except I felt worn out and very tired. Finally, I felt the pain in my ear again two weeks after the first. I said to myself, I probably should go to the doctor, it wasn't really bad pain but my ears felt clogged. Ok, I go to the doctor.. BAM, a double ear infection, I didn't even feel the pain in the other ear. After going on antibiotics, that same day, the pain was so bad it woke me out of a sound sleep, popping sounds in my ear and drainage.

With that being said, I know from previous ear infections (this is the first while on biologics), that I have had high fevers. I'm wondering why this time I did not.

I know this sounds a bit off the wall but I believe that while on biologics, you do get sick and don't know it until it is really bad. Without fevers, how can anyone know that something is wrong?

Any insight to this would be appreciated. I'd love to hear what others have to say. I wonder if anyone shares this thinking.

Sounds like you've got the right idea. I have had the same things happen to me. Just about 2 months ago, I was feeling really down, extremely tired, coughing a little, but not much fever. I had a rheumy appointment during this time, so I asked him what was going on with my body. He checked me out and gave me a flu shot. He said it was hard to tell whether I already had the flu or not because the biologic drugs I am on will mask symptoms and the reduced immune system won't let the body temp go up very much.

Not sure if it was the flu shot or just time going by, but I got to feeling much better the very next day. The rheumy and I had a nice little talk (he talked, I listened). He explained to me, in easy to understand language, how the immune system works and what happens when we take immuno-suppressant drugs. I love my doctor!

You should probably talk to your doctor and get the information you need to better understand things, but as I said in the beginning, it sounds like you've got the basics.

Biologics are more targeted than some other drugs like corticosteroids are. They seek out and suppress inflammatory pathways that cause joint inflammation. There is some suppression of the immune system, but not so much that one should stop developing fevers. Not all infections will cause a fever. For example, I used to have raging ear infections as a child and then again as an adult. When I was little, I always, without fail had a fever. When I went through a bout of them again as an adult, I had none, and the infections were still pretty nasty. I had the membrane rupture, lost hearing, the whole 9. On the bright side, I’ve been on biologics for 4 years now, and I have only been sick once, and it cleared in 5 days. It was very mild, I had a fever for the first day or two, but none after that.

I linked an article for you. It’s about RA, but mentions many of the same drugs. The mechanism of action remains the same.