Medically reviewed by Jenny Blair, MD
Immunomodulators are a class of drugs that treat inflammatory bowel disease (IBD) by modifying your immune system to help control inflammation in your body. As with any other IBD treatment, if you’re prescribed an immunomodulator, it’s important to stick with it. However, two recent single-center studies suggest that approximately 30% of people with IBD who are prescribed an immunomodulator don’t stick to their treatment regimen. Here’s why that’s a bad idea.
1. These drugs are safe and effective.
One common reason people who have IBD don’t take their immunomodulators as prescribed? They have concerns about these drugs. As with any drug, there are certain risks with immunomodulators—they increase the risk of infection and certain cancers like lymphoma and skin cancer, though those risks are still relatively low. And while it’s possible to experience side effects, it’s not common. At the end of the day, experts say that for most people, IBD treatment offers many benefits that generally outweigh these small risks.
2. It can increase your risk of needing long-term steroid treatment.
Steroids do play an important role in treating IBD—they’re very effective at getting an active flare under control quickly. However, long-term steroid use can increase your risk of serious health complications like osteoporosis, cataracts, high blood pressure, high blood sugar, and more. Immunomodulators are known as “steroid-sparing” drugs, meaning that taking an immunomodulator can help reduce the need for steroids long-term. So if you’re prescribed an immunomodulator, it’s important to stick with it in part to help prevent complications from frequent steroid use.
3. You might not be giving it enough time to work.
It can take anywhere up to three to six months to notice an improvement after starting immunomodulator therapy. Experts advise patience—it’s important to give the drug a chance to work.
4. You might be missing an essential part of your treatment plan.
Many people take more than one medication to control IBD—this is known as combination therapy. So if you take an immunomodulator along with another IBD drug, it’s important to take all of your medications as prescribed. They are intended to work together to increase the effectiveness of your IBD treatment plan, and it’s probably not as beneficial to only stick with part of your treatment plan.
5. You could be increasing your risk of a flare.
Another common reason people stop taking these drugs is if they start to feel better. However, if you take an immunomodulator, it can help you not only achieve remission, but also maintain it. And that’s the goal of IBD treatment. If you stop taking this medication without your doctor’s approval, you could be putting yourself at risk for a flare. Experts say that it’s important to continue taking medication, even when you’re in remission.
Remember to Work with Your Doctor
If you’re having trouble taking your medications as prescribed, or if you don’t feel like your treatment plan is working, it’s important to talk to your doctor. Do not stop taking your medication or change how much or how often you take it without instruction from your doctor.
Jenny Blair is a writer and journalist covering science, medicine, and the humanities. She earned her MD at Yale University, then completed a residency in emergency medicine at the University of Chicago. After several years in practice, she transitioned to working with words and ideas full-time. Jenny has contributed to Discover, New Scientist, Washington Spectator, and Medtech Insight, among other publications. She lives in New York City.
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