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06-01-2013, 04:56 AM   #1
littlemissh
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[Submitted] Do any of the biologics have a lower infection risk?

Hi,
I have severe active upper GI/gastroduodenal Crohn's which initially was treated with prednisolone, then azathioprine, then aza plus adalimumab.Now adalimumab only.

I had aza stopped due to persistent neutropenia and ended up with necrotising fasciitis requiring 7 debridements.
Prior to having Crohns diagnosed aged 40, 2.5 years ago I didn't get infections, even minor viral ones.
Since being on adalimumab I have had 2 episodes of severe sepsis - once chest, once unknown source but blood cultures grew eubacterium lentum so presumed bowel in origin. Also had a couple of less severe infections though both requiring iv antibiotics and the latest is bilateral mastoiditis...ouch.

My question is- do any of the biologics offer less risk of infection or are they all similar in risk. My white cell count is generally around 3-4, often with low lymphs and neuts.
My disease is only really controlled with weekly injections, but I have only have had that for a couple of months last year and also currently. It was reduced back to 2 weekly due to my infection risk.
If I do not have adalimumab my upper GI tract tries its best to perforate or exsanguinate me...I had 7 units blood in 24 hours last tuesday.

My other question is - does having weekly injections of adalimumab increase your risk of infection over having 2 weekly or is the risk simply related to being on it regardless of dosing. My white count does not alter on the weekly regime.
__________________
Diagnosed Crohns small bowel 2010,Gastroduodenal crohn's Jan 2012. Gastroparesis june 2014.
Duodenal perforation/peritonitis nov 2011. Portacath placed Nov 2013. Gastric pacemaker 2015.
Perforated jejenum/peritonitis oct 2015, PEJ for enteral feeding nov 2015

On Humira every 7 days, intermittent iv iron, regular blood transfusions :faint:
On TPN since March 2016.

Last edited by littlemissh; 06-02-2013 at 08:03 AM.
10-03-2013, 08:15 PM   #2
David
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