Posted 2/20/2018 2:07 PM (GMT 0)
I would anticipate some sort of positive improvement within 6-weeks of starting Humira as that's when you're most likely to get a response if you are going to. It's not impossible that you might get a response after 6-weeks but it is definitely a whole lot less likely to happen. As an example: When I first started on remicade, I had my first positive signs 3 weeks in, and much larger positive signs at 5 weeks in. I had slow and steady improvements thereafter until I reached a remission. Some respond quicker and others respond slower and the response time should be the same whether it's remicade/humira/simponi.
Entyvio is a slower working medication, I'd wait at least 12-14 weeks for a response on it. Some do respond faster but others can take at least that long.
I wouldn't consider a surgery unless you've failed two different classes of biologics (each class uses a different mechanism of action than the rest, and might work even if others have failed), anti-tnf (remicade/humira/simponi) is one class, entyvio is another distinct class. There's a few other newer classes of biologics stelara is one, and xeljanz is another distinct one. As the medical literature says that after failing two biologics your odds of success are greatly reduced, you start to look like a non-responder to everything. Can another 3rd or 4th class of biologic work for you when the others did not? Sure it does happen, we've had a few successes with stelara or xeljanz when nothing else had worked.
It's always a personal choice on surgery, and a big one is where is your current quality of life? If you have only mild symptoms and impact on your quality of life then it is a much easier decision to keep fighting and exhaust all of the conventional and alternative treatments available for UC. If you are home-bound, incontinent, and in constant pain than surgery is a no-brainer. It depends where you are at, how long you've been on steroids, and how much fight you have left in you. Some try everything first, others throw in the towel much earlier. Surgery isn't a failure by any means, or anything to fear. Surgery is yet another treatment option for those who other treatments have failed, it gives you back your quality of life (we have some posters who've undergone it and are doing great!).
And to throw in some food-for thought:
1.) Make sure you've had multiple failed tests for CDiff, a test known for false-negatives.
2.) Make sure you are using combination-therapy for treating your UC. Not just humira, but also an immunomodulator (imuran/azathioprine/6mp) and also anti-inflammatory mesalamine (lialda/asacol/pentasa/apriso) all concurrently. One medication is seldom a miracle, but the combined affect of multiple medications is often enough to achieve a remission (at least it did for me).