Biologics for Ankylosing Spondylitis: Weight Gain and Edema Concerns

Ankylosing Spondylitis (Biologics)

Hello, Doctor: I have ankylosing spondylitis, and since the medication treatment has not been very effective, my physician evaluated my condition and started me on biologic therapy.
It has been four months since the treatment began, and I have recently noticed some swelling and an approximate weight gain of 3 kilograms.
I apologize for the inconvenience, but I would like to ask if the use of biologics can lead to edema and weight gain? Thank you, Doctor.

Niming, 20~29 year old female. Ask Date: 2015/06/05

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your message.
Currently, there is no clear evidence indicating that the administration of biologic agents causes edema or weight gain as side effects; in fact, the likelihood of side effects is higher with other medications, particularly anti-inflammatory pain relievers or corticosteroids.
If there are no specific medications involved, another possibility is that biologic agents may reduce inflammatory responses, which could potentially lead to weight gain.
I personally believe that you should return to the outpatient clinic to inform your attending physician, so they can review your current medication status, assess the severity of the edema, and identify possible causes.
The Allergy, Immunology, and Rheumatology Department of Changhua Hospital, Ministry of Health and Welfare, cares about you.

Reply Date: 2015/06/05

More Info

Ankylosing Spondylitis (AS) is a chronic inflammatory disease primarily affecting the spine and the sacroiliac joints, leading to pain and stiffness. The treatment of AS has evolved significantly, particularly with the introduction of biologic therapies. These medications, which include tumor necrosis factor (TNF) inhibitors and interleukin-17 (IL-17) inhibitors, have been shown to effectively reduce inflammation and improve symptoms in many patients. However, as with any medication, they come with potential side effects, including weight gain and edema (swelling due to fluid retention).

Weight gain and edema can occur for several reasons when using biologics. Firstly, some biologics may influence the body's metabolism and fluid balance. For example, TNF inhibitors can lead to changes in appetite and metabolic processes, which may contribute to weight gain. Additionally, these medications can cause fluid retention, leading to edema, particularly in the lower extremities. This is often due to the way these drugs interact with the immune system and the vascular system, potentially causing the body to retain more fluid than usual.

Moreover, the underlying condition itself, AS, can lead to changes in physical activity levels. Chronic pain and stiffness can limit mobility, which may contribute to weight gain over time. Patients may find it challenging to engage in regular exercise due to discomfort, leading to a more sedentary lifestyle. This, combined with the potential side effects of the biologic treatment, can result in noticeable weight changes.

It is essential to monitor these side effects closely. If you are experiencing significant weight gain or edema, it is crucial to discuss these concerns with your healthcare provider. They may suggest lifestyle modifications, such as dietary changes or increased physical activity, to help manage these side effects. In some cases, your doctor may consider adjusting your treatment regimen if the side effects are significant or impacting your quality of life.

In addition to these concerns, it is also important to consider the overall benefits of biologic therapy in managing AS. While side effects like weight gain and edema can be bothersome, the primary goal of treatment is to reduce inflammation, alleviate pain, and improve function. Many patients find that the benefits of biologics in controlling their AS symptoms outweigh the drawbacks of potential side effects.

In summary, while biologic treatments for ankylosing spondylitis can lead to weight gain and edema, these side effects can often be managed with appropriate lifestyle changes and close communication with your healthcare provider. It is essential to weigh the benefits of effective symptom management against the potential side effects and to work collaboratively with your healthcare team to optimize your treatment plan. If you have further concerns or if these side effects become more pronounced, do not hesitate to reach out to your doctor for guidance and support.

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