Spondylitis Association of America

tnf , heart and abx.

Posted By: worldofme

tnf , heart and abx. - 05/28/18 02:22 PM

I think my rheum said he would like to put me on cosentyx, assume this is same humira. He said was ok to take with doxy.

1. how does tnf impact heart?

2. anyone take abx and tnf together?
Posted By: SouthernMoss

Re: tnf , heart and abx. - 05/28/18 05:25 PM

Cosentyx is not a TNF inhibitor. It is an IL-17 inhibitor.
Posted By: RAHMBA

Re: tnf , heart and abx. - 05/28/18 07:30 PM

Agree with southernmoss. Conentyx & Humira are different mechanisms. Both are biologics. Both are injections. Both are indicated for AS. They inhibit a different target of the immune system.

Sorry, don’t know about interaction with the antibiotics.
Posted By: worldofme

Re: tnf , heart and abx. - 05/30/18 01:22 PM

Originally Posted by SouthernMoss
Cosentyx is not a TNF inhibitor. It is an IL-17 inhibitor.


What? So it's not an immune supressive?
Posted By: SouthernMoss

Re: tnf , heart and abx. - 05/30/18 01:32 PM

Yes, it is immunosuppresive. As RAHMBA said, Cosentyx inhibits a different target of the immune system. It suppresses the IL-17 cytokine instead of the TNF cytokine.
Posted By: ThreeG

Re: tnf , heart and abx. - 05/31/18 01:00 PM

Hey there WorldofMe! You an I have interacted on some other threads about heart issues. I have WPW and have recently been having a lot of bradycardia incidents. I'm still in the investigative process (wearing a monitor as we speak). This new set of symptoms started about a month after I started Cosentyx. I haven't read that this is a common side effect, and my doctors don't think there is necessarily a connection. That said, it is something to ask about. I started a thread a while back about Consentyx side effects because they were rough the first few weeks (you do 5 loading doses at 1/week, then go to 1/month). There are some good responses there. Good luck!
Posted By: worldofme

Re: tnf , heart and abx. - 06/08/18 02:38 PM

ThreeG:

What does your monitor show so far?

The arriythmia are followed by tunnle vision, blood rushing through the body, feeling fatigue, lighthead and dizzy about to pass out type of feeling it can last anywhere from a min to few min.

The feeling is truly an awful experience one can have. In few weeks I will be going in for my 3rd time holter monitor testing.So far they haven't found anything wrong. However, most recent echo indicates four valves are leaking especially tricupid valve.

I feel AS is def going after the heart in my case & all of the organs.

ThreeG: What happens with your bradycardia symptoms?
Posted By: worldofme

Re: tnf , heart and abx. - 06/08/18 02:39 PM

Are there any proof that TNF prevent heart damage?
Posted By: Winston

Re: tnf , heart and abx. - 06/08/18 04:19 PM

There have been some studies trying to link TNF inhibitors to a lower risk of CVD (cardiovascular disease), heart attacks, and strokes. Most of the studies I've read involved rheumatoid arthritis patients. I think results are mixed in those. There was a study released in 2015 noting a lower CVD risk in psoriasis patients. As for the sort of unique heart problems that spondylitis patients can develop, e.g. aortitis, aortic regurgitation/aortic valve inflammation, conduction abnormalities, I'm not aware of any large studies or trials looking at that. I've had this conversation with my cardiologist and what he told me was that cardiologists do not prescribe TNF inhibitors (or other biologics) precisely because there have been no good studies confirming their effectiveness for heart patients and conditions. Note that there are some case studies and very small studies addressing the effect of TNF inhibitors on a couple of types of vasculitis, Takayasu's Arteritis (TAK) and Giant Cell Arteritis. Those studies are mixed on the effectiveness of the TNF inhibitors in maintaining remission in TAK patients. If I recall correctly, the TNF drugs were not helpful to Giant Cell patients. But I'm not sure any of those studies are terribly valuable given their size. And I'm not sure they say anything at all about spondylitis-related inflammation's effect on the heart and vascular system, particularly the aorta. All these diseases do their damage via different mechanisms.

We're still waiting on the big clinical trial on TNF-a drugs and heart disease. I imagine Big Pharma would love to be able to market biologics as heart disease drugs (then everybody in the world will be on them); so hopefully we'll get some data soon.

Note that just because there's no conclusive data saying TNF-a drugs prevent heart damage doesn't mean TNF-a drugs don't prevent heart damage.

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