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Anyone been on Tacrolimus for short term?

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Ulcerative Colitis
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Posted 8/2/2017 7:21 PM (GMT 0)
Hi All -

I was in the midst of a moderate UC flare, then I came down with E.Coli. Needless to say, this has left me in a not so good state. After a brief hospitalization on IV steroid and home on a 40mg Pred wean down, I'm still not feeling great.

My doc wants to start Tacrolimus for short term salvage therapy since predinsone is not cutting it before things get worse. Then, the plan would be to start Xeljanz as a maintenance therapy once I was feeling better.

I've never heard of these options before. Since I go to a research hospital, I know they are on the forefront of new meds.

Has anyone tried either? They both sound scary and I'm not sure about it.

Any insight from my fellow UC peeps would be great.

Thanks!!
Posted 8/2/2017 7:45 PM (GMT 0)
Hmmm not at all common. Usually rescue treatments are IV Steroids, IV Cyclosporine, or IV double-dose Remicade/infliximab (a tnf-alpha blocker). Scratch the IV Steroids if you are steroid-refractory.

Here's a pubmed article talking about the lot of these with IBD patients:
/www.ncbi.nlm.nih.gov/pmc/articles/PMC4479736/
Posted 8/2/2017 7:50 PM (GMT 0)
Thanks so much, John. When they said they wanted to start this course of treatment I was def caught off guard. Of course the more I research online the more I freak myself out. I'm thankful for all your insight and the article. Much appreciated!!
Posted 8/2/2017 10:36 PM (GMT 0)
I would give it a shot. Tacromilos is supposedly more effective than cyclosporine and if you are not responding well to steroids this could pull you out of your flare. Xeljanz is a good plan too..I did well on Methetextrate for a while so these drugs for arthritis ccan often work.
Posted 8/3/2017 3:04 PM (GMT 0)
Thanks so much, Poppie. At this point, I just want to start to feel better so I might have to do it. They just don't seem like the traditional route for UC treatment, so was looking for any experiences.
Posted 8/3/2017 5:24 PM (GMT 0)
I agree, both are definitely not the traditional route. The thing is that as long as it gets you out of a flare what the heck!! When I was in the hospital recently (long story) they were going to give me Tacromilos as it works well, but somehow someone messed up and I ended up with Remicade instead (crazy) and then they switched it to Humira LOL!!! ....but I wanted it so badly, anything to get me out of a flare!

Xeljanz is a fairly new drug and so there is not a lot of data with regard to helping UC, but as I said I found Methotrexate to work very well. I am interested in Xeljanz too if it turns out that Humira doesn't work for me.

http://www.fiercepharma.com/marketing/pfizer-s-xeljanz-shores-up-case-for-ulcerative-colitis-expansion
Posted 8/3/2017 9:16 PM (GMT 0)
Thanks, Poppie!! My doctor said that the FDA will be approving Xeljanz for UC use in spring of 2018. He already has patients on it, so for now it has to be preapproved by insurance and that takes up to 3 - 6 weeks. So, the hope is to start with the tacromilos and then switch once approved as the Xeljanz is used as a maintenance drug to keep you in remission.
Posted 8/4/2017 2:11 AM (GMT 0)
I'm going through the insurance hoops to get on Tacrolimus for my UC. I've had bad reactions to AZA and 6MP, tried methotrexate, but that didn't work either. They want to use it as a bridge until I'm on Xeljanz for a while.

Speaking with the doctors about it, it seems like it's a similar drug to other immunomodulators, just with reduced (but still onerous) side-effects.
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