Taking more than one biologic at the same time
I was diagnosed with UC 30 years ago and have been on a biologic since 2006. I had 104 infusions of Remicade before it stopped working and then tried 4 other biologics until we (my Dr. and I) finally found one that worked. I have been in remission for almost 5 years now. In the meantime, I have had asthma most of my life. When I was on Remicade it seemed to keep my asthma in check. But now that I am on a different biologic (Stelara) that is geared only to UC and Crohn's, my asthma has become steroid dependent. Both my allergist and my gastroenterologist want me to take a second biologic that is geared to the asthma so that I can get off the steroids and relieve all the nasty side effects of long-term steroids use. Needless to say, I really want to get off the steroids, but I am concerned with what being on two different biologic medications would do to me. Is anyone else on multiple biologic medications for multiple autoimmune disease?
Hi
. Comorbid conditions certainly create treatment issues and it is understandable that you would be leery about duel biologic treatments. There doesn't appear to be a lot of research on the topic, but there is some. I found this article focusing on asthma and rheumatic conditions (some of the biologics for these overlap with IBD): https://pmc.ncbi.nlm.nih.gov/articles/PMC9923700. I also found this article focusing on a specific biologic often used for asthma in combination with other biologics: https://www.annallergy.org/article/S1081-1206(25)00203-0/fulltext. There was another study from the British NHS specifically on IBD and asthma, but there is no way to share it. It notes that no adverse events were recorded in the cases they studied, but the time-frame was a limiting factor. The decision on whether to try the duel-therapy is, of course, up to you. I hope this information is helpful. Did your doctors offer any information or thoughts on the risks? Wishing you the best. Richard (Team Member) Richard,
Thank you for your help with this. I'll definitely take a look at the articles you included. Neither doctor offered any information on taking dual biologics, both saying they were not sure of what the risks would be but would look into it before my next appts with either. Both thought that since biologic meds are geared towards individual autoimmune issues, they would not cause any adverse effects on each other. We did look into going on a second biologic when I was on Remicade but determined that it was not a good idea back then.
ErikaIt's been 2 months now that I have been on the dual biologics. Two weeks after the initial dose of the new Biologic my UC decided it was time for a flare. It got bad really quick. I went on an increase of the steroids that took about a week to get it under control and am still weening down. Other than that, I haven't had any other symptoms. Neither of my doctor's think that the new biologic caused the flair. They think it was just coincidence. Hopefully their right. On the plus side it seems that my asthma is getting better. I haven't needed my rescue inhaler in 2 weeks. Hi
. Thanks for the follow-up. Let me start by saying glad to hear that you are seeing a positive change with your asthma. I can't speak on whether the new biologic might have triggered the flare (who knows what something new introduced into a complex system can do), but it is telling that there have been no issues since. As you know, it can take a while for the full effect of biologics to happen, so hopefully you will continue to see improvement. Best, Richard (Team Member)
Thank you, I will
I am on Entyvio and Tymlos (for osteoporosis.)
Hi
. Thank you for sharing. I know that it is thought that Entyvio, through reducing inflammation, may reduce the risk of osteoporosis. Were you already diagnosed and did doctors think the IBD may have been a factor? Has the Tymlos helped slow the bone loss and do the drugs seem to be working well together? Wishing you the best. Richard (Team Member)
