Will Using Biologics Cause Flairups If Stopped?

[Spot On]

I am curious to know if I try some drugs (biologics etc.) for PsA and Ps and I stop them will I get a rebound flairup like I used to when I used topical steroid creams?

[Turnedlight]

Er.. I’m not sure, I’ve tried 4 or 5 now but the derm has never really given me a big gap before going on the next. Also, if the bio is working then the plan is to stay on it.

The usual reason for stopping one is because it’s stopped working for you, therefore at that point you’re already having a flare up, or at least gradually getting worse, before you have given it up.

I don’t know what happens if you achieve remission on a bio and then try and stop hoping to keep clear.

The best success I had was Stelara, I would say my skin was cleared by it at one point but I carried on with it to maintain the success. Sadly after about a year it stopped working.

[KatT]

I had a break of about 5 to 6 months of treatment a few years back because of lupus flare up.  The psoriasis did come back but went away when I started the new biologic.  I think I was going from Stelara to Cosentyx.

[Caroline]

Yes, it is a chronic disease. If you take away the suppressor then it will come back. It may be that, if in the mean time you changed a bit of your lifestyle, it comes back in a different way, e.g. less OR worse, but that is unpredictable.

[Fred]

I would say there is a very good chance that a flare up would come if one stopped a bio. You have to look at it like Caroline said, the treatment suppresses the problem so if you stop it is very likely to come back.

When covid started I checked with some bio makers and my dermatologist and they all suggested I keep taking the Tremfya I had not long started as they felt it would cause a flare.

Having said that, some people can go into remission. Wooley did with acitretin, not a bio but it is possible.

[Kate]

Here's my experience with stopping Cosentyx.
In March 2020, my Derm advised discontinuing injection because of possible affect of Coronavirus on those with compromised immune system. I did not experience any flare up of psoriasis. In fact it was quite the opposite. A gradual decline of my mild symptoms occurred and here I am over one year later completely free of psoriasis. 
Two events have occurred which may explain my amazing recovery. Firstly, my 5 times weekly trips to the swimming pool have been replaced by a few trips  to the seaside for much longed for swims between lockdowns. Secondly, in November 2020, I was diagnosed with Polymyalgia Rheumatica (another immune system malfunction)which necessitates steroid medication. Perhaps this is what is keeping symptoms of psoriasis at bay. Perhaps it is skin response to freedom from chemical laden pool water.  My GP tells me that psoriasis will return once I can stop taking steroids for PMR. 
Best wishes for a successful outcome

[mataribot]

It depends on your body and how long a usable amount of medication is in your body. If you have PSA there’s a good chance of flare afterwards, since most medications only slow down the progression of the disease.

[Spot On]

With steroids it's not only the return to where one was before the treatment, but the Ps comes back with a vengeance worse than before. That's what I am asking about.

I understand if you stop the drug it will return, but will it return worse than before, and not just the amount it might have progressed, but way worse? That was my experience with topical steroid creams.

[mataribot]

Most people don’t have steroid like flares afterwards, but cannot say 100%

[mataribot]

If you’re super scared of a rebound flare, you can ask for a secondary treatment like UV.