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112 points wglb | 6 comments | | HN request time: 0.746s | source | bottom
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eveningsteps ◴[] No.43684375[source]
Surprisingly enough, this partially exposes the link between depression and some of the autoimmunal diseases. One example is how patients with psoriasis have significantly elevated levels of proteins from the IL-17 family (namely, IL-17A, IL-17C, and IL-17F) - up to 4 to 8 times above nominal values.

At the same time, bimekizumab, one of the bleeding-edge psoriasis and psoriatic arthritis treatments, suppresses production of IL-17A and IL-17F (methotrexate does that, too, albeit to a much smaller degree). As a result, people receiving IL-17 suppressors become happier over the course of years, and not only due to months-long remission - I had a chance to see this in one of the experimental treatment programs.

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1. hirvi74 ◴[] No.43687182[source]
Based on your knowledge and experiences, do you think the benefits are worth the potential side-effects?

I fully understand that after a certain point of disease severity, the right choices tend to become more apparent. However, I have been offered such medications in the past, but I have always refused.

From what I understand, many of the serious side-effects are rare. However, once Pandora is out of the box, it's not always easy to get her back inside.

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2. Vecr ◴[] No.43687968[source]
Pedantic note: Pandora was the woman who opened the box. Pandora was not in the box. The problems of the world were, along with hope. Maybe you're mixing the story with the phrase "the cat's out of the box" ?
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3. spondylosaurus ◴[] No.43688150[source]
If you have the kind of autoimmune issue severe enough that people are offering you biologics, the answer to "is it worth the risk?" is almost always yes, imo.

Unchecked inflammation is guaranteed to wreck your health, whereas treatments for that inflammation only have a slim chance of major side effects. For cancer risks specifically, it's worth considering that (1) you have a fighting chance to beat cancer, whereas an autoimmune condition can cause permanent and unfixable damage, and (2) autoimmune diseases are themselves associated with cancer risk. So for something like colitis, which is associated with bowel cancer, your overall odds of getting cancer are exponentially lower with treatment than without. (And less serious side effects usually go away when you stop the medication :P)

It's also worth noting that newer biologics are more like a sniper than a shotgun, so the immunosuppression is pretty targeted; still worth being careful, but it's not like the vulnerability that comes with, say, chemotherapy.

4. eveningsteps ◴[] No.43690708[source]
In my opinion, yes. Echoing the sibling comment, having a large amount of distributed skin lesions, or any joint pain at all makes one reconsider their options. Surface-level treatments might be very uncomfortable to apply and wear and provide only temporary and unstable relief, as well as UV sessions. Unless you live by the seaside or would like to go there several times a year to keep the skin clean, it's infeasible as a long-term solution. On the other hand, the quality of life improves immensely with injections - the symptoms _just_ disappear, which no diet, or lifestyle change, or application, or alternative medicine, or other supportive care can achieve in the majority of patients.

It goes without saying that your situation may be different, but most people I know opt for them meds, choosing Bimzelx, or a similar treatment (Taltz (ixekizumab) or Skyrizi (risankizumab)). The only downside is the cost, but it may be very well possible to wring it out of your insurance, especially in Europe.

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5. hirvi74 ◴[] No.43692897[source]
Crap, you are right. I had a lapse in memory for a moment. Thank you though.
6. hirvi74 ◴[] No.43698296[source]
I guess that is what makes things somewhat difficult for me. If I could not see my condition, then I wouldn't even know I had it. I have no symptoms that prevent me from doing anything I need to do in life (knock on wood). I am actually more on the mild side of the spectrum of disease severity.

So, that is why I find it unusual that doctors have offered biologics in the past. I do remember one doctor made a comment to me. She said it was unusual that I do not want biologics because most, if not all, of her patients beg for them regardless of the disease severity. Maybe she is getting kickbacks or something? I have no idea.

Basically, that is the root of my question. Are the risks worth it for someone that has maybe 1-2% coverage of lesions across their entire body? Sure, it'd be nice to go from 1-2% to 0%, I guess, but I cannot get a good understanding on the risks.