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Your first biologic always gives the best results?

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Ulcerative Colitis
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Posted 12/23/2015 2:04 AM (GMT 0)
I had my remicade infusion today and the infusion nurse said: "Your first biologic (no matter what it is humira, remicade, etc.) always gives the best results". It's been in my head ever since, she didn't cite a source, not sure if it's based on personal experience or opinion...

Does it seem to be true for those of us who've tried multiple?
Posted 12/23/2015 2:11 AM (GMT 0)
Not true with me . I did 2 infusions of Remecade that gave me muscle spasms so that ended that
Humira I took for 14 months with no results
However Entyvio kicked in at 6 infusions with good results
We are all different ! turn
Posted 12/23/2015 2:16 AM (GMT 0)
not true for me. i did remicade, humira, and now simponi. it's the only time i've been in remission for a long period of time. took my first shot of simponi december 26, 2013!!
Posted 12/23/2015 2:41 AM (GMT 0)
Biological or anti-tnf medication? Entyvio is a different class of biological than the usual anti-tnf like Remicade that we normally start with.

Remicade worked great for about 5 years for me, maybe it would have worked longer if I had combined it with 6-mp like what is more common today. The other anti-tnfs haven't worked for me after Remicade (see my signature).
Posted 12/23/2015 2:42 AM (GMT 0)
This isn't true for me either. I tried Humira first (while on 6MP) and my flare continued to get worse. I switched to Remicade (while continuing the 6MP), saw significant improvement over the course of a couple of months, and was in remission for almost a year.
Posted 12/23/2015 2:53 AM (GMT 0)
4 years ago when my GI brought up my options...either Humira or Remicade, he told me that if one or the other didn't get me into remission then the other might not work as well. Not sure how true that is because I chose Remicade over Humira (mainly because I didn't want to give myself shots and the frequency) and as my first biologic, it worked wonders for me.
Posted 12/23/2015 3:02 AM (GMT 0)
I think the response rate is highest for people who have never failed to respond to another biologic. So statistically some one taking a biologic for the first time is more likely to respond well than some one who already tried and failed with another. But for any individual it might the 2nd or 3rd biologic that works best for them.
Posted 12/23/2015 4:30 AM (GMT 0)
Simponi was my first and I have absolutely no result. If that was my best, I guess it wasn't any worse than any others...
Posted 12/23/2015 9:05 PM (GMT 0)
Dr. Feagan, one of the heavy hitters in the IBD world brought this idea up to me a few weeks ago too. I dont think any research has been done on it and that its mainly based on anecdotal clinical experience
Posted 12/24/2015 1:12 PM (GMT 0)
Casey_LB is right, it's a statistical trick -- like saying if you're looking for a lost item, "it's always in the last place you look." Statistically speaking, if you fail treatment, that makes it more likely that you have aggressive disease and that subsequent treatments won't work as well. The direction of causation runs opposite to what the nurse implied (it's not that switching biologics makes you less likely to respond, it's that if you switch it's probably because your disease is poorly controlled and therefore less likely to respond to any treatments).

Think about it this way: if I told you that person A has been on Remicade for ten years and person B has tried Remicade, Cimzia, Simponi, Humira, and three study drugs, just based on that information, who would you think is doing better?
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