Considering Biologics for Ankylosing Spondylitis: My Concerns
Hello, I'm a 21-year-old female recently diagnosed with ankylosing spondylitis (AS), and my physician has recommended biologic medications for my treatment. However, I have reservations about this approach due to the immunosuppressive nature of these drugs. My history with MRSA, which is currently dormant, makes me anxious about the potential risks; I worry that being on an immunosuppressant could heighten my susceptibility to infections caused by my compulsive skin picking linked to OCD. Additionally, I have a history of exposure to black mold, which has caused me significant health issues. Now, even the slightest presence of mold makes me ill, and avoiding it seems nearly impossible. This adds to my apprehension regarding the potential for a heightened risk of illness from the medication. While I am well aware of the consequences of untreated AS and the importance of addressing it, the fear of living in constant anxiety due to the effects of an immunosuppressant is daunting. Am I simply uninformed about the function and safety of biologics? Are my fears justified? Are there alternative treatments that don't involve immunosuppressants? I would be grateful for any insight. I plan on discussing this with my doctor, but I aim to gather as much information as possible before making a final choice. References or resources would be greatly appreciated, too.
Answers (1)
8/3/2025, 9:50:46 AM
OpenHealth AI
It's understandable to feel apprehensive about starting biologic medications for ankylosing spondylitis (AS), especially given your medical history and concerns about infections. Let's break this down.
Main Points
- Biologics can be effective treatments for AS but do carry some risks, particularly regarding infections due to their immunosuppressive effects.
- Your history with MRSA and mold exposure raises valid concerns about potential risks.
- Alternatives to biologics exist and can be discussed further with your physician.
Explanation
Biologics are medications that target specific parts of the immune system to reduce inflammation effectively. These can improve mobility and relieve pain associated with AS. However, because they can lower your immune response, there is a potential risk for infections. Your past with MRSA and sensitivity to mold certainly heightens these concerns.
It's essential to balance the benefits of treating AS—such as pain relief and preventing complications like fusion of the spine—against the risks associated with the medications. Your anxieties about the potential for increased susceptibility to infections are entirely valid.
Next Steps
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Consult with Your Physician: When you speak with your doctor, express your concerns about immunosuppression, your history with MRSA, and mold exposure. Ask specifically about monitoring strategies or precautions that can be taken while on biologics.
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Explore Alternatives: Inquire about non-biologic treatments, such as:
- Nonsteroidal anti-inflammatory drugs (NSAIDs): These can help manage pain and inflammation.
- Physical therapy: Strengthening and stretching exercises can improve mobility and decrease pain.
- Disease-modifying antirheumatic drugs (DMARDs): Some may be less immunosuppressive than biologics.
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Educate Yourself: Consider seeking reputable sources for more information on AS and treatment options, such as:
- National Resources: The Arthritis Foundation and the Spondylitis Association of America offer literature and support for patients.
- Clinical Guidelines: Look for recommendations from rheumatology societies that detail treatment options for AS.
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Monitor Your Health: Keep track of how you respond to any treatment adjustments, and be vigilant about managing factors that may increase your risk of infection (e.g., practicing good hygiene and avoiding environments prone to mold).
It's commendable that you are seeking information and aiming to make an informed decision about your treatment options. Please know that addressing your concerns and ensuring your comfort with the chosen treatment is paramount; there are multiple paths to effectively manage ankylosing spondylitis.
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