Simponi, golimumab

Is anyone currently using simponi for aggressive Crohns?

There are some trials showing promise, though it is used more for UC.

Thanks.

I had a very successful 9 year run on Simponi. It worked wonderfully on both my Crohn's and am ankylosing spondylitis. Keep in mind that when I was first diagnosed with Crohn's I was told it was "mild." I was put on biologics not long after my diagnosis and have been on them pretty much ever since.

My GI likes either Simponi or Stelera for his CD patients. He is a well known Crohn's specialist in my area.

My brother was on it for a few months, but he has UC, not Crohn's. He got a good initial response after the loading doses; but after that he was only getting a partial response. His insurance wouldn't approve testing for his trough levels or for a higher dose, so he switched to Remicade.

He has gotten a very good response on Remicade.

I know that's not what you asked, but it brings up an issue - Remicade, Humira, and Simponi are all anti-TNFs. Remicade has the disadvantage of being an infusion but the advantages of weight-based dosing, well-established tests for trough levels and antibodies, and the possible advantage of getting the anti-TNF to travel in the body to where it needs to be better than the injection forms of anti-TNFs.

If you're anti-TNF naive, Remicade is the best to start with.

If you've already been on Remicade and failed, then whether or not to try Simponi depends on how/why you failed Remicade. If you were a primary non-responder (ie, it just didn't help at all), then Simponi probably won't either. If you responded well but lost response (due to antibody formation or hyper-efficient metabolism of the drug by your body), then another anti-TNF like Humira or Simponi makes sense.

I think data will soon show that Simponi is about as good as Humira, but that both are a *little* behind Remicade. That's a semi-educated guess on my part, so I could be wrong.

Interesting - can you share a link or more info about the recent trial showing Simponi worked when Remi and Humira didn't?

Hmm, I think I've attended a presentation by one of the study authors - and once met his sister.

I hadn't heard anything about this - quite the opposite, in fact (that if Remi and Humira don't work, there's not much reason to try Simponi). I wonder if any other studies confirmed the findings presented here.

There are a few other small studies with similar results. Simponi is slightly different in that it has an affinity for both soluble, and trans membrane tnf.

Ask your friend Beave