Hi, we’re gonna talk about risks and benefits of biologic medications. If you have an inflammatory arthritis like psoriatic arthritis, rheumatoid arthritis, or ankylosing spondylitis, you may at some point in your treatment be offered a biologic medication. These are medications such as TNF inhibitors, which would include Enbrel, Humira, Simponi, Simponi Aria, Remicade, Cimzia, or a T-cell modulator, like the drug Orencia, or a B cell depletor, like the drug Rituximab, or an IL-6 inhibitor, Actemera. Now, you all have heard TV commercials which are giving you some risks of these medications and I think that what I would like to do is help you understand, or put into context, what those TV commercials are really saying. So the one question I get most frequently is does this drug cause cancer? Well the answer is probably not. What we know is that people with an inflammatory arthritis are more at risk for infection and for lymphomas than the normal population. So for example, if you had a stadium, let’s say it’s in a high school football stadium, where there are 10,000 people and none of those people had any type of a, an inflammatory arthritis, there may be about two people in that group of 10,000 who would get lymphoma. Now if you took that same stadium and you filled that 10,000 seat stadium with people who did have inflammatory arthritis, maybe four people would get a lymphoma. Now, if all 10,000 people were also on a medication like a TNF inhibitor, then maybe four people would get a lymphoma. So the risk doesn’t go up with the treatment, really. And what we might start to see in some of the data is that the risk of lymphoma actually goes down. I think that, hopefully that will help you make a more informed decision whether this would be the right treatment for you or not. There’s also risks associated with not having any treatment and the risk with that is that right now you are as good as you’re gonna get. So the question is, do you wanna stay that well and continue to decline, or do you hopefully wanna get back to the function that you once had. Those are things as well that you really will need to discuss. Another issue is to look at the risks of the medications that are, that you’re currently taking, that do have significant risks and side effects associated with them. And the main culprit being Prednisone. Prednisone has a lot of horrendous side effects including things like hypertension, high blood sugar, glaucoma, delayed healing, diabetes, so you really wanna weight the risks of all of your different treatment options and discuss with your provider which is gonna work the best for you.