This week’s radio show features one of our favorite guests, Dr. Robin Chutkan. She is a gastroenterologist in Washington DC and has excellent communication skills. You can listen on your local public radio station or receive her stream live at 7am ET on your computer or smartphone at wunc.org. Here is a link so you can find out which stations are broadcasting our broadcasts.
We will talk about some of the most successful drugs in pharmacies. They are called “biologics” or immunomodulators. You are probably familiar with the following brand names: Enbrel, remicade or humira. What effects do these drugs have and what are their drawbacks? If you can’t listen to the broadcast, we recommend listening to the podcast later. You can subscribe through your favorite podcast provider, download the MP3 using the link at the bottom of the page, or listen to a stream of this post starting October 9, 2023.
Advantages and disadvantages of immunomodulatory drugs:
The immune system has many important jobs, including fighting off infections and scanning the body for cancerous growths. But sometimes it can go a little crazy and start attacking normal tissue. This is the reason behind autoimmune diseases such as psoriasis, rheumatoid arthritis, and ulcerative colitis. Doctors have many ways to treat these symptoms, but the most powerful drugs are monoclonal antibodies like infliximab (Remicade). The “mab” at the end of the common name is the signal for a monoclonal antibody.
Remicade and other immunomodulating drugs, such as Enbrel and Humira, calm the immune system and reduce inflammation. That is why they can be very useful in serious situations. Doctors call them “biologics.” This is because they are produced by living organisms, in this case primarily cells. As a result, they can be difficult to manufacture, so the pharmaceutical companies that produce them charge top dollar prices.
Price isn’t the only drawback:
Even with adequate insurance coverage, some of these drugs can cost thousands of dollars a month. Many people may feel discouraged when they think about the out-of-pocket costs. But cost is not the only consideration. If you’ve seen any TV commercials for these drugs (and there are a lot of them), you’ve likely heard a long list of potentially serious side effects. These drugs reduce immune system activity, which can make people more susceptible to serious infections such as tuberculosis. Additionally, a weakened immune system makes cancer surveillance less effective. As a result, the risk of developing a tumor may increase.
Dangers of newly discovered immunomodulatory drugs:
Scientists have recently discovered another surprising result of these drugs (Clinical gastroenterology and hepatologyJuly 10, 2023). Patients in France and Denmark taking any of these drugs for ulcerative colitis may develop further autoimmune conditions such as psoriasis, psoriatic arthritis, rheumatoid arthritis, or a devastating skin disease called hidradenitis suppurativa. They were 76% more likely to develop the disease. Doctors use biologics to treat these symptoms. Until this study was conducted, they believed that people taking such drugs were protected from further autoimmune diseases. That’s why the results were so unexpected.
Discontinuation of immunomodulatory drugs:
If you want to stop taking these biologics, you should work closely with your health care provider. Dr. Chutkan noted in an interview that he has helped many patients rely more on dietary changes and lifestyle modifications so they don’t need more medications. However, stopping is not a do-it-yourself project. For some drugs in this category, the dose may need to be gradually reduced to avoid flare-ups. People who are unwell may not be ready to stop taking their medication. Therefore, discontinuation requires cooperation from patients and healthcare providers. Some people may never be able to stop. Only your doctor can help you make that decision.
Other digestive drugs that are difficult to stop:
Proton pump inhibitors are among the most popular drugs for common digestive disorders such as heartburn and ulcers. Esomeprazole (nexium), lansoprazole (Prevacid) and omeprazole (prilosec) has long been considered safe enough to be used without a prescription. However, it is not as harmless as some doctors assume. Additionally, many people find it can be difficult to stop taking any of these acid suppressants without medical supervision. Dr. Chutkan explains the challenges and how to overcome them.
Gastrointestinal effects of diabetes and weight loss drugs:
Semaglutide is approved under two different brand names for two completely different (but not completely unrelated) purposes. Ozempic Used to treat type 2 diabetes and control blood sugar. wegobee Helps reduce appetite and lose weight.
Since they contain the same active ingredients, it’s not too surprising that they have similar effects on the gastrointestinal tract. In addition to nausea, vomiting, diarrhea or constipation, semaglutide may cause more serious complications. Gastric emptying may be significantly slowed, a condition called gastroparesis or gastroparesis. In addition, the lower part of the intestine may also stop functioning. Doctors call this condition ileus. Both can be dangerous.
This week’s guest:
Dr. Robin Chutkan, a board-certified gastroenterologist, is on the faculty of Georgetown University Hospital and founder of the Wellness Digestion Center, an integrative gastroenterology practice in Washington, DC. Dr. Chutkan is the author of several books on digestive health. Got Bliss, microbiome solution, Treatment for swelling and Antiviral Gut: Tackle pathogens from the inside out.
Robin Chutkan, MD, author of The Anti-Viral Gut: Tackling Pathogens from the Inside Out
Listen to the podcast:
The podcast of this show will be released on Monday, October 9, 2023, after the October 7 broadcast. You can stream shows and download podcasts for free from this site.
Download mp3.
