If Pred doesn't work, will Humira/Remicade?

So two weeks into another Pred taper, i'm seeing only a slight improvement. I head back to my GI in 2 weeks and know he is going to push me towards the biologics.

But I am wondering, if Pred isn't having this instant remission effect on me, why would the biologics?

Biologics like Humira and Remicade are antibodies that work like sinks to neutralize inflammatory molecules (specifically TNF-alpha). It's a systemic effect, much like prednisone, but unlike pred, they're meant to be used long-term. Additionally, because they're more specific in their mechanism of action, the side effects from them are much less common than the ones from pred.

I haven't taken pred for anything chronic in about 5 years (yaaaaay), but I was on high doses of it at the same time that I was flaring several years ago. It didn't do anything for me at all. In contrast, Remicade was practically life-saving.

You need to keep in mind that instant remission isn't always a thing. What are you on besides prednisone? Pred is supposed to knock down inflammation enough for other medication to work; if you're just on pred and nothing else, then I'm not sure what your doctor is even thinking.

Also keep in mind that you don't have to take any medication you don't want to. There are other options besides biologics (e.g. 6MP or aza).

I started Humaria about a month ago and with that, I was able to taper off my prednisone where I wasn't able to before without a flare up. I am in the middle of a flare up now, even while on Humaria but I can say that it is not as bad as it was with previous flare ups. I think this is a good medication but probably need more time to really evaluate it.

Neither Prednisone nor intravenous steroids worked for me, but I've been in remission for over 2 years so far on Remicade.

The first time I was on pred it took 3 months to get my flare under control. After that it took weeks to months w/pred. I'm on remicade only now for over 2 years.