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Remicade, Humira, neither??????

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Crohn's Disease
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Posted 5/23/2010 1:31 AM (GMT 0)

My new Gi is adamant about me starting Remicade or Humira and I am not sure how I feel about it.

History- I have had digestive problems most of my like….constipation, diarria and just general problems. June 2008 I started to get very sick. 6 months of laxatives, diet changes, a few x-rays and blood tests, gaining 15 pounds then loosing 20 I went to the ER one night and the doc there referred me to a GI. My doctor finally agreed and I went for the normal borage of CT Scans, colonoscopy etc… and I was diagnosed in March of 2009 with Crohns.  I had a short course of steroids which didn’t do much, tried Entecort, Pentasa, and a few other first choice meds. In May my pain was unbearable and was in a very specific spot so I went in for another CT \Scan which revealed an abscess and a small whole. My walls were inflamed to a point that was nearing blockage. In June 2009 I had a resection.  After I healed from surgery I felt great! I have had my blood checked twice and my SED rate was really low and I hadn’t had even a small flare so it seemed I was good for now.  2 weeks ago I started a pretty bad one.

My new doctor (I have seen him twice now) says that my disease is progressing way to fast and I didn’t respond to previous treatment so he wants me to try a biologic. I know what a big decision this is and I want to be sure I am making the best choice. My argument is that by the time I was diagnosed my intestines were so damaged that the meds didn’t have much of a chance to work. I feel like maybe now a lower risk med might work. I haven’t tried 6MP or any other higher risk med. I told him this and he says that we might not have time to try other meds. If I wait and the disease progresses I might be looking at another surgery which I am not ok with until I don’t have another choice. I am awaiting on blood tests to come back to be sure I am even a candidate and also am scheduled for a CT Scan next week to see how bad the inflammation is so I have some time to decide but I need help. Is there any logic in my feeling like we should go back to the old meds first?

Thanks SP

Posted 5/23/2010 1:39 AM (GMT 0)
The older meds take a longer time to work (up to six months or more)...and as far as immunosuppression, are similar...ALL have side effects (Imuran gave me pancreatitis), Methotrexate can be hard on the liver, not to mention the B vitamin issues...as I stated in the post just previous, most often they are now using biologics as a first line med to induce remission...it DOES work fast, if it is going to work...

Oh, and the ASA meds, just help keep you in remission, but cannot really get you there...
Posted 5/23/2010 1:42 AM (GMT 0)
How often will I need to have injections? For how long? My entire life....I'm only 26. Can it affect my future fertility?
Posted 5/23/2010 1:51 AM (GMT 0)
There are people here who have had children while on Remicade or Humira...I do not believe, for the literature that I have read, that these medications affect fertility...however, the OLDER meds, methotrexate/Imuran, CANNOT be taken if you want to have a child (if I remember correctly, this is due to defects esp in 1st trimester)

The frequency and length of time you need to take these meds is entirely dependent on your doctor, your disease, and your needs...each case seems to respond just a bit differently...With Humira, it is a self injectable, usually once a month...Remicade, it is infusion usually 1x/8 wks, but could go up, depending on how you react...

But think of it this way, you have a disease that you are going to have for the rest of your life...I hope you achieve and keep remission...and other diseases you have to take meds for life (ie diabetes)...so an injection once a month to keep away pain and surgery, to me, (JMHO) totally worth it. wink
Posted 5/23/2010 2:07 AM (GMT 0)
Humira is typically used one shot every 2 weeks (after an induction period). Cimzia two shots every 4 weeks. Remicade is IV every 8 week (after an induction period).

You can expect that you'll likely stay on the drug as long as it's working. Who knows about the rest of your life as the medication and treatments for Crohn's are constantly being researched...
Posted 5/23/2010 2:20 AM (GMT 0)
Is it typically expensive? I have good insurance but what can I expect to pay for Remicade?
Posted 5/23/2010 2:43 AM (GMT 0)
My Remicade infusions cost around $6,000 each time I went (every 8 weeks). I only had to pay my copayment and they do have a program called Remistart that helps pay your deductible etc. I would definitely contact Centocor and your dr about RemiStart.
Posted 5/23/2010 5:29 AM (GMT 0)
Sorry, I forgot, my bad...been awhile since I was on the Humira...it is every 2 weeks...Cimzia is supposed to be once a month...but I take it 2x/month...

Oh, I have Cimpay to help with the coverage of costs...and I think Humira might have one (I saw this in my Rheumatologist office a few months ago)...
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