Have you had increased infections on RA meds? (Not sure what TC stands for in context, but I'm guessing you take biologics.) Maybe I'm the outlier, but spending several years on TNFis hasn't lowered my immune threshold in any noticeable way, knock on wood.

Oral steroids, on the other hand... when I go on those every fungal creature in a ten-mile radius decides to take residence on my skin. Nasty fuckers.

I did take biologics and did have an uncontrollable (skin related) infection. Not life threatening but life altering. I stopped the biologic and within 2 weeks the infection was gone.

Ouch! Glad it cleared up after you quit the meds, at least.

Most of them are defacto immune system suppressants

> When they say "you may be more prone to infection" take it very, very seriously.

I suppose it depends on the disease. I have read rather conflicting research about whether certain DMARDs/Biologics actually increase cancer rates, infections, etc..

I'm about the furthest thing from a expert one can be in regards to this topic, but I will say that I have always purposely tried to stay away from those medications "just in case." I am also in a fortunate enough situation that I am not required to go on such medications despite having the option in order to live a mostly normal life.

I'm not some "big pharma bad" person, but something about those medications have never sat well with me. I suppose for many, the risk of the cure outweighs the risk of the disease. But in regards to something as integral as the human immune system, I real do not want to "fuck around & find out" as people say these days. Until there is a legitimate cure or safer medicines, I suppose I am (dis)content with the level of disease activity I currently have.

This is great if your particular immune disorder doesn't kill your ability to walk or eat or type, but the increased cancer risk definitely seems worth not having to comparison shop foot-pedal mice.

I've read that the increased cancer risk isn't so much an increase in cancer rate as a reduction in bodily policing of early cancers?

> This is great if your particular immune disorder doesn't kill your ability to walk or eat or type

Mine can, and still might, it just *fingers crossed* has not happened yet and hopefully never will. However, I do have many of signs that have a high correlation with such outcomes. =(

The cancer is not my concern. For my disease in particular, the research, from what I have read, seems to believe that biologics do not increase the rate of cancer more than what the AI disease already does. Some studies have shown that there might even be a decrease in cancer once inflammation is controlled.

With that being said, it's the other potential side-effects like new incidents of Demyelinating diseases, Lupus-Like Reactions, seizures, liver damage, heart failure, etc..

The biologics seem to be getting safer with each iteration, and I would feel more comfortable on something like Skyrizi than Humira or Enbrel, but still not comfortable enough to pull the trigger.

Back story:

8 years ago, I had a minor sore throat and flu-like symptoms for about three days, then I was back up an running. Less than two weeks later, I was diagnosed with an autoimmune disorder. Thus, I am quite hesitant to open the doors for more infections. As the saying goes, "You can't put shit back in the horse."

You also can't get functionality back that you lose to your autoimmune disease if you later decide you've had enough and start treatment.

Preventing that damage in the first place is the key.

Unchecked autoimmune diseases tend to raise cancer rates, too. In which case now you have cancer and an active autoimmune condition... so you should've just taken the meds in the first place :P

Plus, as I've rationalized it for myself: you have decent odds of surviving cancer if it's caught early enough, but damage to your organs/skeleton is permanent and irreversible.

> In which case now you have cancer and an active autoimmune condition

Good, then the chemo can kill two birds with one stone. ;)

I'm kidding, but it's not like people without AI diseases are immune to cancer. So, I'd imagine it'd be kind of hard to definitively link causality.

Everyone is focused on the cancer side-effects, but that honestly seems like a lesser concern to me than some of the other potential side-effects of some of the biosimilars.

> damage to your organs/skeleton is permanent and irreversible

There are a lot of cancer survivors that would agree and are living examples of this statement too. Surviving != a full recovery.

> a lesser concern to me than some of the other potential side-effects of some of the biosimilars

Biosimilars as in, Infectra vs Remicade? I haven't heard of anything in that vein :O

Also if the chemo wipes out your immune system apparently you can start fresh (Hematopoietic Stem Cell Transplantation).