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Stelara, Humira, or Zeposia?

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Ulcerative Colitis
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Posted 8/17/2021 2:54 PM (GMT 0)
I need a new biologic, ever since I got my Covid shot( j and j) in June I’ve been flaring. Did pred for 6 weeks and was better but as soon as I dosed down bleeding came back and flare. Just received another Entyvio last Monday and it did nothing. My GI wants to change my meds. Stelara, Humira, or Zopesia which is brand new pill biologic. He wanted messalamine enemas but my insurance wouldn’t cover it. Any suggestions?
Posted 8/17/2021 2:59 PM (GMT 0)
I don’t have recommendations but want to rant at insurance! That’s stupid they won’t cover something that can help you! Have you appealed? Or checked prices on GoodRx or another like it? What about steroid enemas/foam? I think uceris foam (which I always found super soothing) might have a copay program.
Posted 8/17/2021 4:20 PM (GMT 0)
I think I would go Stelera. Although, I had an interesting conversation with a GI from Europe who stated he is having very good results with Ozanimod. Interestingly, he said Skyrizi (riizankimab) is also having good results but it is not FDA approved for IBD.
Posted 8/17/2021 4:21 PM (GMT 0)
Why would you try Zeposia vefore Xeljanz? Or have you already tried Xeljanz? Sorry, I can't remember. I wouldn't try Zeposia myself because it's so new, unless possibly I had no other options. The side effect profile is also pretty scary. I can't believe your insurance won't cover mesalamine enemas. That's ridiculous. Have you already tried Remicade? If so, it's really up to you. The efficacy seems similar for them all. I find self-injections much more convenient than infusions myself.
Posted 8/17/2021 4:26 PM (GMT 0)
I’ve been in Remicade, had bad side effects from that. Tried to get on Xeljanz but insurance wouldn’t cover that until I try Humira. My doctor also suggested maybe doing Entyvio every 6 weeks but I’m not responding to that. I really liked Entyvio.
Posted 8/17/2021 4:28 PM (GMT 0)
I see. I'm surprised insurance would cover Zeposia and not Xeljanz then but maybe you haven't checked yet? Good luck with whatever you decide.
Posted 8/17/2021 4:51 PM (GMT 0)
I would agree with Sara14 that remicade should be looked at. Certainly, well before Humira and I would for sure do xeljanz over Zeposia.
Posted 8/17/2021 9:12 PM (GMT 0)

RyanC said...
I’ve been in Remicade, had bad side effects from that. Tried to get on Xeljanz but insurance wouldn’t cover that until I try Humira. My doctor also suggested maybe doing Entyvio every 6 weeks but I’m not responding to that. I really liked Entyvio.

If you've been on Remicade and had bad side effects then you probably want to forgo Humira because they are very similar medications. My bad side effects from Remicade I also had with Humira, Simponi and Cimzia.

Stelara is fast acting and using a different mechanism. My GI told me that it is more effective in CD patients than UC. I had to get the correct dosing but it's been good ever since I received the IBD dosing instead of the psoriasis less dose(I was taking offlable before the FDA approved it for IBDs at the higher dose).

Are you taking 6MP or Imuran?
Posted 8/18/2021 1:05 AM (GMT 0)
Zeposia is doing free medications for 2 years right now according to my doctor and the rep but for me it seems way 2 new of a medication. It’s primary use is for MS. I’m heading towards stelera.
Posted 8/18/2021 12:51 PM (GMT 0)
I'd choose the same in your boat.
Posted 8/27/2021 11:01 PM (GMT 0)
I agree with the logic of other posters that if Remicade didn't work it makes sense to try different mechanisms first rather than another anti-TNF. That's also the advice my IBD nurse gave me recently after I came off Humira, switched to Xeljanz, and am about to switch again.

I was given a choice of Entyvio or Stelara, and I've chosen Stelara first as I'm hoping it'll also resolve joint and fatigue problems.

Did you make a final decision? I'll hopefully be starting on Stelara around the end of Sept (the IBD team need to apply for NHS funding so the paperwork takes a bit of time).
Posted 8/28/2021 12:05 AM (GMT 0)
My GI put in the order for Stelera Wednesday. So hopefully sooner then later. I’ve been flaring since July 1st. Im so tired of being on prednisone!!! I want my life back and to feel somewhat normal. Stuff makes me depressed. The pred isn’t even working. I still have blood every morning and through out the day.
Posted 8/28/2021 10:19 AM (GMT 0)
I hope you start to feel better soon Ryan. Prednisolone massively affects my mood and doesn't work for me either (even IV pred) so that's why I take Clipper (gastro release beclametasone) when I have no choice but to take a steroid.

Have you tried Cortiment (budesonide) or Clipper (beclametasone diproprionate) before? Cortiment didn't work for me either but for some reason 5mg of gastro release Clipper works quite well when I need it.
Posted 8/28/2021 10:28 AM (GMT 0)
As I'm UK based I don't know much about US private healthcare options but I was a bit shocked that your insurance won't cover enemas. Is it the same for suppositories? For those of us who aren't allergic to it rectal mesalazine (mesalamine) is an important part of our treatment.

Like I said, I don't know how the US system works, but is there a way for someone challenge the insurance company?
Posted 8/28/2021 2:00 PM (GMT 0)
You can appeal the decision but it’s time consuming and when you’re flaring …. The doctor has to write a letter explaining why a certain drug is necessary so some pencil pusher looking at a book of drugs can say no. It’s very frustrating
Posted 8/30/2021 8:38 PM (GMT 0)
Ryan and UCyousee: I really hope the new meds help you both. Please keep us updated.
Posted 9/1/2021 1:54 PM (GMT 0)
I was on Humira for 4 years and it worked great for me.

Sadly. I went off it for about 6 months (my choice. I was in full remission and I wanted to try drug free, and see if I could manage my UC through just diet and exercise. Bad decision). Then when I started having UC issues I went back on Humira. But it didn’t work then. Because during those 6 months my body built up antibodies against it.

I’m now trying Xeljanz. Monday morning QB…I should have never taken a Humira break.
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