I start my first dose of Humira tomorrow - first experience with a biologic - and I understand it makes you more susceptible to infection. Do you take precautions to avoid illnesses? Is it like people who are on chemotherapy needing to avoid people who are sick?
Just want to take proper care of myself and wondering if you had to make any accommodations in your life when you were taking Humira?
TIA!
Very very few people fall victim to the infections and illnesses which they worry about when they think about starting a biologic. We have many members, in fact, who work as teachers and nurses who manage just fine. Do we take precautions? Yes, we wash our hands, avoid touching our faces and try not to get too close to someone who is clearly sick, but for me that's the same set of precautions I took before I was on a biologic. Oh, and most of us have taken the shots that our doctor recommends -- annual flu shot, shingles vaccine (before starting) etc.
Don't forget that rejecting a biologic when it is recommended, carries its own set of significant risks in the way of joint destruction and damage to quality of life, family activities, social life and career. One of the things that my biologic has allowed me to do is exercise (I do rather energetic water-physio), which I think has made me fitter and probably more resistant to disease than I was before. It's not simply a question of "Do you want to take this drug that is going to make you susceptible to all kinds of other diseases?"
The biologics work on one tiny protein in a the giant machine of our immune system. It doesn't knock out the whole works by any means!
Thank you! That makes me feel much better - I was afraid I was going to catch everything I was exposed to. This forum is awesome for real information from real people with experience - much appreciated!
I'm due to start my first biologic this week, and had been wondering the same thing! Thanks for asking the question, and best of luck on Humira :-)
I’ve been on humira for over 4 months now and used Enbrel for about 5 months prior to that. I have been more vigilant about hand washing and using sanitizer but for the most part done little different. I have only been sick (colds, flu, mild stuff) in the same amount as I normally would have been without a bio. I would say that the two colds I have had on Humira (very germ sharing work environment and school age children this is my norm in winter months) have been more lingering and a little harder to get over. This said so far the benefits of a working bio outweigh that. Less fatigue, more range of motion, reduced swelling… I still consider myself in the gap but getting closer to closing it complely soon. Seems like drug companies are trying to cover every end of avoiding lawsuits so they warn about everything under the sun which can sound scarier than the drug often is for most people. Generally with autoimmune diseases our systems work overtime on healthy parts of our body so reducing it to a normal or less confusing state is good long term. Meaning to say I would rather have my immune system work on a cold or disease rather than healthy, needed parts of body anyway. Either way I see nothing to fear but doing nothing.
As Seenie said, for most people the increased risk is minimal. I take the same minimal precautions that I have always taken. I have school aged kids and I put extra kids on the bus in the mornings. As a matter of fact, my husband gets sick more frequently and more lingering than I do, and he's not on any meds. I even missed out on the dreaded stomach bug last time that my crew got sick.
I've been injecting Humira 3 years this past January. Before Humira, every year, I got bronchitis at least once and sometimes twice (spring and/or fall/winter). In the last three years, I've had it once--in early January of this year. I think the reason for being sick less often is because I have less inflammation and the bronchitis beasties can't take hold the way they did.
I'm not a teacher or a nurse but I do go into penal institutions all over the Commonwealth of Kentucky--not the cleanest of environments, either the physical plant or the inmates.I wash my hands more and try not to touch much. Frankly, I'm more concerned with susceptibility to measles/whooping cough. My rheumy and I are working on a plan to see what my vaccination titers are and go from there. He won't allow me to have shingles vaccine.
That’s an interesting point, sixcat, about less inflammation meaning less susceptibility to bugs. I’m no doc, but it makes sense.
I had the shingles vaccine before I started the biologic. I doubt my doc would allow me to have it now.
And you brought up another excellent point: this disease, besides inflaming joints and tendons, can attack and inflame any number of other body structures. Eyes are a common target, as are bowels. But we’ve heard of lungs (as you said) and hearts too. It’s just not a simple equation. I’m looking much better than I have in decades since starting the biologic. Maybe it’s the exercise that I can do now. Maybe it’s the fresh air because I go out more. Maybe it’s better nutrition 'cuz I don’t have the runs every morning. Who knows! It’s more a case of becoming (perhaps) a bit more susceptible, but also becoming generally healthier because of lack of inflammation interfering with your body functions and your life.
And we may as well bring up the C-word. Without getting too technical (we leave that to tntlamb, our medico-technical guru) the very slightly increased risk of certain cancers is offset by the fact that most of said cancers are curable. (The stats for teenage boys, are, apparently different, but we don’t have a lot of those here.) Do I want cancer? No way! Am I willing to assume a slightly elevated risk of a likkely-curable cancer in return for years of pain relief and quality of life? Hell yes! To be honest, before I got the biologic, I had moments when I wished, oh I wished, that PsA was a terminal illness. Honestly. A horrible admission, but there it is.
Great point! Thanks!
Rachael said:
I've been on humira for over 4 months now and used Enbrel for about 5 months prior to that. I have been more vigilant about hand washing and using sanitizer but for the most part done little different. I have only been sick (colds, flu, mild stuff) in the same amount as I normally would have been without a bio. I would say that the two colds I have had on Humira (very germ sharing work environment and school age children this is my norm in winter months) have been more lingering and a little harder to get over. This said so far the benefits of a working bio outweigh that. Less fatigue, more range of motion, reduced swelling... I still consider myself in the gap but getting closer to closing it complely soon. Seems like drug companies are trying to cover every end of avoiding lawsuits so they warn about everything under the sun which can sound scarier than the drug often is for most people. Generally with autoimmune diseases our systems work overtime on healthy parts of our body so reducing it to a normal or less confusing state is good long term. Meaning to say I would rather have my immune system work on a cold or disease rather than healthy, needed parts of body anyway. Either way I see nothing to fear but doing nothing.
This is a really good point - I was actually wondering/hoping less inflammation would make a difference to me as I have a touchy kidney and have had infections from time to time, urologist says its inflamed more often than not. Hopefully this will knock that down. Thanks!
sixcatlawyer said:
I've been injecting Humira 3 years this past January. Before Humira, every year, I got bronchitis at least once and sometimes twice (spring and/or fall/winter). In the last three years, I've had it once--in early January of this year. I think the reason for being sick less often is because I have less inflammation and the bronchitis beasties can't take hold the way they did.
I'm not a teacher or a nurse but I do go into penal institutions all over the Commonwealth of Kentucky--not the cleanest of environments, either the physical plant or the inmates.I wash my hands more and try not to touch much. Frankly, I'm more concerned with susceptibility to measles/whooping cough. My rheumy and I are working on a plan to see what my vaccination titers are and go from there. He won't allow me to have shingles vaccine.
Oh, I can relate to that. Thanks for all the information - invaluable to me right now!
It's making me look forward to this first injection today!
Seenie said:
That's an interesting point, sixcat, about less inflammation meaning less susceptibility to bugs. I'm no doc, but it makes sense.
I had the shingles vaccine before I started the biologic. I doubt my doc would allow me to have it now.
And you brought up another excellent point: this disease, besides inflaming joints and tendons, can attack and inflame any number of other body structures. Eyes are a common target, as are bowels. But we've heard of lungs (as you said) and hearts too. It's just not a simple equation. I'm looking much better than I have in decades since starting the biologic. Maybe it's the exercise that I can do now. Maybe it's the fresh air because I go out more. Maybe it's better nutrition 'cuz I don't have the runs every morning. Who knows! It's more a case of becoming (perhaps) a bit more susceptible, but also becoming generally healthier because of lack of inflammation interfering with your body functions and your life.
And we may as well bring up the C-word. Without getting too technical (we leave that to tntlamb, our medico-technical guru) the very slightly increased risk of certain cancers is offset by the fact that most of said cancers are curable. (The stats for teenage boys, are, apparently different, but we don't have a lot of those here.) Do I want cancer? No way! Am I willing to assume a slightly elevated risk of a likkely-curable cancer in return for years of pain relief and quality of life? Hell yes! To be honest, before I got the biologic, I had moments when I wished, oh I wished, that PsA was a terminal illness. Honestly. A horrible admission, but there it is.
I have been on enbrel 9 weeks and methotrexate 3 so far ok without side effects. I am a school teacher and I come in contact with close to 600 kids a week. I was very worried I just also try to wash my hands a lot.
I wish you hadn't made me say this Guinnie, because I suffer greatly from 'pride before a fall' syndrome. It's not actually pride, but you know what I mean. Anyway, here goes: I've been on Humira since June 2014 and I never get anything. Except one cold at a time when everyone had that same cold. It was unpleasant but I got better rather quicker than most. I work with the public one day a week in a stuffy building, a lot of people I see are at a low ebb and aren't necessarily in the best of health. I've just got back from holiday during which I got bitten & scratched by a stray cat & also got prickly pear needles embedded everywhere - no infection has ensued though I really thought my luck had run out that day. I think most people on biologics are the same.
I think I've been on biologics for 6 years now? Ish? Anyway, I don't really recall being sick-sick at any point. Like Seenie said, I do get my vaccines (flu, pneumonia, wasn't able to get the shingles vaccine before bios), I've had my titres checked for everything else because of my job and had boosters, and get my TB screening annually. Maybe an occasional cold will lay me out for a day or two, but it usually passes before it feels full blown. I have found that I really, really hurt any time there is a fever, but that's more likely because of the PsA or fibro. In the beginning, I was super cautious around sick people or when flying, but not so much anymore.
There are a small group that do find they get sick more or that bugs overstay their welcome, but it's much fewer than you might think.
I am one of the rare people whose white blood cells have dipped below the normal range since I've been on Enbrel. At first, my rheumy said if my WBCs keep dropping, we'd have to discontinue Enbrel. But after the level dropped again, he said it was OK because part of my WBCs are still in the normal range. I really haven't researched this--I'm just trusting my rheumy and hoping I can stay on Enbrel.
I have been sick more often since starting Enbrel 21 months ago. I had two colds last winter for a total duration of 10 weeks--which was very unusual for me. I had strep throat last August, which was also weird because nobody I knew had it.
I refused treatment for the colds and let them run their course, but when I had strep the doctor put me on penicillin and I recovered really fast--and he checked my WBCs and they had shot way up--a good indicator my immune system had also kicked in to fight off the strep.
I just finished 10 days of Tamiflu because our grandson who I went on vacation with last week had Type A flu right before our vacation. I told my doctor and she didn't hesitate to put me on Tamiflu to avoid catching it from him.
My doctors seem very concerned when I'm ill or I've been exposed to things--my low WBCs concern them. I use every precaution short of a mask to fend off germs!
Tried Humira for three months. Was in a lot of pain. Rhrumy stopped the Humira. Six months later I was diagnosed with bladder,prostate, and pelvic lympnodes cancer. Could this be related? Btw I’m cancer free!
Hi Guinnie,
How are you traveling on the Humira now? Did it give results?
I’ve been on Humira for nearly 4 years now. During that time, I travelled to Burkina Faso (west Africa) and stayed in the mud hut villages you see on National Geographic around 15 times.
I will admit to once getting salmonella (self treatemtent with the antibiotics in my travel kit and I was right in a day), but that’s probably a low proportion for Burkina Faso standards!
Other than that, I’ve not been more susceptible to anything than any of my ‘healthy’ workmates.
Like many others that have posted, I actually get LESS colds, flus, and complications of these on biologics, all while getting very good relief on the Humira. It’s not perfect, but I consider myself a very lucky lady 
I have been on Humira since 2011. If I feel myself getting sick yes I do stop the humira because your body cannot fight as good. I have had flu shot, pneumonia shots. when I have had shots for covd virus I stop both humira and MTX for two weeks per my dr.
Interestingly, the guidelines seem to be somewhat variable for biologics and MTX, and they may be specific to the individual based on past history. For example, I don’t hold off on my meds unless I’m running a fever or have some other infection. I hold as directed for surgery as well. Most vaccines I have been instructed that I DON’T have to hold meds.
I was told to go off PsA meds before and after shingle vaccine. Which I only did the first jab and then all the covid stuff, a season of bad flares etc and still haven’t gotten it. I was told the second shingles shot kicks like a mule! The first one left me very flu like.