HELLO from France

Hi, no good results for me, I started with Stelara on the 30th of November and the third one on the 6th this month and unfortunately no change concerning the consistence of my stools...I had some different analysis of my blood that revealed food intolerances with cow milk, casein and nuts even if I never drink cow milk in general or cream. My Candida test is negative.
In general, how long do we have to wait with Stelara and hope to see a result ?
I think that the next step will be Xeljanz or Rinvoq, which one is the most efficient for UC?

Stelara is an IL-12 and IL-23 inhibitor. Mirikizumab is a more targeted inhibitor of IL-23 only. Risankizumab is also a more targeted IL-23 inhibitor.

There are some studies showing the targeted IL-23 inhibitors may be superior to the combined IL-12/23 inhibitors, ie, Risankizumab might be a little better than Stelara, statistically speaking.

But if you fail an IL-12/23 inhibitor like Stelara, I wouldn't think the next medication to try would be a targeted IL-23 inhibitor. I would think it's too similar to the method of action of Stelara and that you would want to try something in another class. But I don't know that for sure and I'm not sure there is any data one way or the other for that.

Mirikizumab was just granted FDA approval for moderate to severe UC in the United States back in October 2023, so it's quite new. Phase 3 trials for its use for Crohn's disease were positive, and it may soon get US FDA approval for Crohn's disease as well.

So sorry you have struggled for so long! This disease totally sucks the life out of you. I was in a flare from 2010-2014 so I understand the pain and constant hospitalizations. It is hard to keep going but I hope you are able to keep trying medications if that is what you want to do. I am in a mild flare but was in a worse one last year so I am not happy that Rinvoq fizzled out on me so quickly. The meds we have now just don’t work great.