arthritis and iritis while on Entyvio

As far as the arthritis is concerned, are you talking about Rheumatoid arthritis or Osteoarthritis? The treatment for both is very different. For you eye issue, I would see an ophthamologist as the right eye drops should help clear that up. They might prescribe one that does have a steroid in the drops.

Lastly, nuts of any kind are generally an avoidance food. Even when not flaring, and symptoms totally under control, I think you should still avoid things like nuts, seeds, popcorn, corn etc. just to err on the side of caution.

I have been thinking back to when I was having such a bad time with the crohns related arthritis. There is a good chance the entyvio is causing this issue. It is not uncommon for these medications to cause joint pain. When is the last time you were scoped? Disease activity can also cause this, it’s going to be one or the other. When the dr drained fluid off your knee did he send any of the fluid off to be analyzed?

You asked about IV steroids in the RA forum. It may or may not work & it’s up to the rheumatologist. I honestly don’t know that I would go this route because it will not be a permanent fix. As far as causing joint damage usually it’s people with AS. I had active disease going on so this was addressed with meds. My gi said to see my pcp for a mild pain reliever. In today climate PCP’s no longer will prescribe pain medications.

I think you need to discuss a scope & possibly a different medication.

Hmm, I had thought I posted already, but my post seems to have gotten lost. Anyways, I have heard that Entyvio can cause joint problems, but my initial presentation of Crohn's started with arthritis, and I've had subsequent flares of arthritis after that well before I started Entyvio. Also it's not just joint pain, it is arthritis with a lot of swelling, I'm not sure if that's what manifests from Entyvio, and I have been on Entyvio for 3 years with no issues before, not that they couldn't arise later, but I really don't think it's the Entyvio causing the arthritis, especially since I have iritis currently as well. The only time I didn't flare with the arthritis was when I was on Remicade and Humira, but they didn't keep my gut from being inflamed.


Yes, my Rheumatologist did send out the fluid from my knee to the lab. She didn't say anything about it, but when I went to my referral to another Rheumatologist, she said that she saw those results and the fluid was highly inflammatory. What else would they be looking for when they send it out to the lab?


I was last scoped in December, and I'll get scoped again this December. I have zero gut symptoms and usually in the past when I've flared with extra-intestinal symptoms, my gut symptoms have mirrored with their intensity. I feel like Enytvio is doing a good job of keeping my gut symptoms in check while other things flare. I'm really afraid to go off Entyvio since it's the only thing that has worked for my gut long term, and I don't have many options left. I think the only other one is Stelara. I've been on Remicade, Humira, Methotrexate, Sulfasalazine, LDN and now Entyvio and Imuran.

Does anyone know how common it is becoming to combine biologics? I saw on another forum that they're beginning to try Entyvio with other biologics, but I'm sure it would be really hard to get insurance to cover it, and of course there is the worry of a very suppressed immune system. I'd like to know what other people are on for their Crohn's arthritis.

Also does anyone know if medical marijuana helps with inflammation or does it only help with pain? I don't need anything for pain, but I really need to figure out something to help my joints and iritis while on Entyvio.

Hi Susie,

Thanks for your reply. I will check into Beave's posts.

I have had major pain with my Crohn's arthritis in the past. I usually never take pain medication even when in pretty severe pain. I'm not saying that to be some kind of martyr, I just had some once while I was in the hospital and it made me feel very weird, so I just didn't ask for it again. Also I worry about becoming addicted to pain medication, so I just deal with it. But for this flare the pain is not very bad, nothing compared to my past experiences. Perhaps the Imuran is keeping it from getting worse but not keeping it completely in check, I don't know.

Yes, I have been going back with my eye doctor for the iritis. I really am afraid of having permanent vision changes, so I will stay on top of that. I'm just hoping to find something that can keep it from returning so frequently.

That's interesting that MM is so expensive and not something that I took into consideration. I don't necessarily want to go on it, I'm just getting desperate to get out of this flare.

Thanks, Caia. Is the Plaquenil for pain only or does it help with inflammation? I'm fine with dealing with the pain, I just want something to reduce the inflammation.

Thanks, Straydog. My Rheumatologist never mentioned it as an option, and I do wonder if the reason why was because I already have eye issues.

Hi Sparkleplenty,

Wow, I'm so sorry that you haven't been able to get relief from your crohn's without having joint and other issues. Do you have Crohn's related arthritis or is the joint pain only from the biologics? And were you on Methotrexate in combination with the biologics? Was that specifically for your joint pain, and how long did you try it out? What are you on now that you've stopped Entyvio?

I do want to clarify since the title of my post probably seems misleading, that I don't think Entyvio is the reason for my arthritis or iritis. I've had arthritis well before I was on Entyvio, I've never experienced joint pain from any biologic, and actually the two biologics I was on previous to Entyvio (Remicade and Humira) did a great job keeping my arthritis in check but not gut.

I'm trying to figure out what people who have Crohn's arthritis do in combination with Entyvio since Entyvio is gut specific and doesn't help with extra-intestinal manifesations.

Unfortunately, I don't think sulfasalazine did anything for my arthritis. I took it when I was first diagnoed in conjunction with prednisone, but I ended up needing Remicade to get out of the hospital. Years later I took it again after I flared really badly in my pregnancy. I didn't have any arthritis pain for about a year and a half, but it must have been a hormone-induced remission, because as soon as I got my cycle back, I flared horribly with everything including debilitating arthritis. However my arthritis is much worse than my gut symptoms, so maybe if yours is not so bad it would work. It seems like you're allergic to sulfa drugs though, possibly, since you broke out in hives?

Yeah, Stelara was suggested as really the only other biologic option left, but I was told they don't have a lot of studies on if it controls iritis, so I'm not especially looking to switch from the only thing that has helped my gut long term, Entyvio.

I feel terrible that it's also the only thing that has ever worked for your Crohn's but it gave you such horrible side effects! It really isn't fair.

I did ask my Rheumatologist about Cellcept which is a drug that can help with arthritis and iritis, and she said it may be an option. I don't know if you'd want to look into that. It's an anti-rejection immunosuppressant. I don't know much else about it.

I hope you can stay in remission. Who had you come off the Entyvio, your GI or Rheum? Is your GI concerned?

Hi Susie,

Thanks for the follow up. I don't believe I had my knee x-rayed, just other joints that had been affected. I'm not trying to dispute you, but do you have any links about Crohn's arthritis not arthralgia not causing joint damage? Up until this year I thought Crohn's arthritis wasn't damaging, but when I looked further into it, it's the arthralgia- joint pain without inflammation, not the arthritis that is non-damaging. I also asked my rheumatologist and my referred to rheumatologist about it being damaging, and they both confirmed that yes it is damaging due to the constant inflammation, however it usually takes years for it to show up on x-rays. I will check out arthritis.org and see if it can shed some more light on this subject, but it makes sense to me that anything with constant inflammation, such as the inflammation that is in our guts, would cause damage over time. Believe me, I would love it if it wasn't damaging, it would be a big stress reliever for me.

I'm sorry, yes I do understand that RA is a completely different disease, I just don't know if that many Crohn's patients have arthritis and since Crohn's is an inflammatory arthritis, I thought it may have some similarities. I also did a search and was kind of shocked how low of doses they are prescribed comparatively. I did ask my Rheumatologist if she thought trying another dose of steroids would help starting at a higher dose. Last time I did 60mg but it didn't resolve everything. If I'm on 80 for a week and things don't seem to be much better, I will probably call and see if I should taper it. I don't know why, but I feel bad like I'm second guessing her when I ask, but I'd like to minimize any risk.

I've been on IV steroids in the past which is well above the equivalent of 80 mg/day, so maybe that's why she prescribed a high dose for so long. Obviously I would like to not have to be on it, but my flare is getting worse instead of better. I am set to start Methotrexate with Imuran, which for religious reasons I'm not very sure how to navigate things with the Methotrexate, but I'm hoping maybe that will get me back into remission and I can then go back to just Imuran.

OG, CCFa.org is another excellent source, along with all of the major arthritis websites. I know it gets nuts at time when we have the extra-manifestation issues with this lovely disease! But your knee issue may not be crohns related.

I have a long history of knee problems. When a person has to have their knee drained because of excess fluid & have issues for the lengthy period of time as you. I am truly amazed the rheumatologist has not ordered an MRI of your knee. There are several different things that can cause swelling & inflammation. What I am talking about has nothing to do with crohns. At this point, plain film xrays would be useless because the MRI is much more definitive than a regular xray. I am not sure how perceptive your rheumatologist is to suggestions, but even your PCP can order it. Your insurance should approve this without a problem given your history.

OK, I just looked at my labs my Rheumatologist gave me, and one of the diagnostic codes is "spondyloarthropathy" which I looked up on arthritis.org but it's kind of confusing since it says it may or may not involve the spine and it includes other degenerative forms of arthritis as well as Crohn's arthritis. So am I understanding it correctly that even if you have Crohn's arthritis that involves the spine, supposedly it isn't damaging unless it's AS?

Oh yes, when I had my knee drained (6 syringes worth :0! ) she also injected some steroids into my knee, and I've had extreme relief with that plus the high dose steroids. So your joint pain just from the Entvio caused cartilage loss?! Or was it something else? That's just crazy if it's from the Entyvio.

Yeah, I wouldn't think your GI would be that happy about stopping your meds, but I totally agree that the extra-intestinal symptoms, especially the arthritis, can be worse and much more debilitating than the gut symptoms. I hope you can maintain remission and get all your joint pain to dissipate.