12-10-2017, 02:38 PM   #1
my little penguin
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Stelara and EBV

Ds is on Stelara
Are the concerns for EBV infection the same as humira or remicade ??
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DS - -Crohn's -Stelara -mtx
12-11-2017, 01:08 PM   #2
Scipio
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EBV flare-up is an issue with immunosuppression in general but I haven't seen any reports linking it specifically to Stelara. I think the bigger culprit with respect to EBV is azathioprine.
12-11-2017, 10:09 PM   #3
my little penguin
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Thanks
Ds is a teenager and has probably been exposed to mononucleosis
His team of docs said they know what the risks are with remicade /6-mp /aza etc...
But the risk as far as they can tell is unknown for Stelara with methotrexate
12-12-2017, 11:20 AM   #4
Scipio
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With Stelara the big risks are squamous cell skin cancer (keep him out of the sun and use hats, long sleeves, and sun block when sun is unavoidable) and TB flare-up - I assume they tested your son for TB exposure before starting him on Stelara. It would be malpractice if they didn't.
12-12-2017, 11:31 AM   #5
my little penguin
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He has been on biologics for over 7 years
He was dx at age 7
Remicade and humira prior
He has been tested yearly for tb including prior to starting them
And uses excellent sun protection (thick pure zinc oxide as a physical barrier /long sleeve /safari hats etc.... )
As well as dermatology visits every few months (Sweets Syndrome as an extra )

But thank you for the reminder in case other reading were not aware

ETA
Stelara is not a risk factor for tb
It affects Il 12 and il23
Not anti tnf alpha
The tnf alpha is needed to fight back against tb
So higher risk for tb on remicade humira etc...

The mechanism is different
It also doesn’t carry a black box warning
But out of caution they still do tb tests until they have more data
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