Remission and Meds

For those of you in remission — have you successfully dropped any meds? I guess I’m specifically asking about remission due to a biological and if you stayed on oral mesalamine

I’m in remission due to entyvio and thinking about dropping Apriso (mainly due to the cost of Apriso and other mesalamines).

Do you know of studies/research about biologics and mesalamine? Or studies about stopping mesalamine and if it’s effective again at a later date if re-started? Do we develop antibodies to mesalamine?

Thanks!!!

One does not build antibodies with mesalamine. It's a topical and not systemic and in a whole other class and action in how it works.

My suggestion is to find another oral cost-wise and rectals of maintainance schedule.

I've used them well over 30 years, but have never been on any other meds....so my info may not be helpful to your question.

q

Good answers thanks! As mesalamine never put me in solid remission on its own (hence the entyvio) looks like I’d be a good case to discontinue it!

If you want to test the waters a bit you could cut your dosage in half.

I recall a study where taking psyllium husk was almost as effective at maintaining remission as mesalamine but I don't recall the details so you would have to Google it and draw your own conclusions. Just something to look into. Not a recommendation one way or the other.

Yep I think I will have to convince my dr. I asked him last year about cutting my dose down and he said no.

Natural curl - I hear you on the mesalamine rat race. I just sent in my prescription list for prices but I know trying to get prices with all the different options makes me a pain in the neck to the advisor. I also need to add Rowasa to my list — have never used it yet but I feel I should probably start if I cut my Apriso.

I also need to research mesalamine and diverticulitis tho as I think there was some evidence it can help with that? And if so that’s a strong consideration for my situation as I still have lots of diverticuli in what’s left of my colon. Anyone have any info in that regard?

Our gasteroenteroligist's goal is to get us down to just the biologic once in a sustained remission. For many that is all we need to sustain a remission. Once in a sustained remission, your gasteroenteroligist will have you taper off of your weakest meds. It's a discussion to have with your gasteroenteroligist after sustaining your remission. As always, one size does not fit all, your results will vary, void where prohibited by law, etc etc. Some patients do need more meds to sustain a remission.

It would be pretty typical, if you've been in a remission for 2-6 month,s to reduce one mesalamine, wait another 6-months and remove a second mesalamine, and wait another 6-months to remove the 6mp/imuran. Often, that means stopping any rectal-route meds 1st, quit the mesalamine enema or suppository. 2nd, you quit the mesalamine oral. 3rd, you quit the azathiopurine/imuran/6mp. And you stay on the remicade/entyvio/humira for the duration of your remission. You just want to be cautious, watch your symptoms carefully (and perhaps check Calprotectin/C-Reactive Protein a couple times a year). If the taper of any one med is unsuccessful then add back in that med and not remove any further meds at that point, as some of us might need multiple meds in order to sustain a remission.

There's always risk in tapering down any med, as it is certainly possible you could flare again. We are guessing what we need less in order to sustain a remission and there is sometimes failure when changing things. If you are standing on a stool with 4-legs, you can start kicking legs off of that stool and be fine for a while, eventually you will topple though!