HealingWell
Search Close Search
☰

Humira vs Remicade

Support Forums
>
Ulcerative Colitis
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 3/15/2013 11:28 PM (GMT 0)
so after a year of humira, it looks like I am finally stopping it. bottom line if it was effective, it's definitely lost it's effectiveness now. doctor is pushing hard for me to start remicade next week, after my colonoscopy he personally got the ball rolling with my insurance company. i went from hating the guy to liking him, he was wonderful today. as much as i tried not to get emotional i couldn't help it, it was a rough day and I got while I got the news i was fully expecting, i didn't really want to hear it. entire diffused colon, deep ulcerations and small hemmies to add insult to injury.

so here's my question, how different is humira vs remicade. is there a decent chance that I will respond favorably to remicade where humira has failed. ive read positive responses after infusion therapy can be as short as 2-3 days - a week, is that true? also i understand the loading phase is 1st infusion, 2 weeks later, and then every 8 weeks, is that true? i've read conflicting things about that...
Posted 3/15/2013 11:34 PM (GMT 0)
Remicade has put me into a wonderful 2 year long remission while Humira didn't do anything for me at all. I hope Remicade will help you. Good luck.
Posted 3/16/2013 12:03 AM (GMT 0)
remicade gave me 3 months of normalcy while humira gave me tons of hospital bills. i'd pick remicade in a heartbeat. it stopped working too quickly but my UC was pretty non existant while i was on it.
Posted 3/16/2013 4:00 AM (GMT 0)
They are identical in mechanism as they both bind anti-TNF. Remicade is an older drug and contains murine a-human TNF Fab fragments whereas Humira is fully humanized (hence the name). If you are following off therapy because binding up TNF is no longer suffecient to stop the disease, switching drugs will likely not help. Some patients develop antibodies to the drug (frequency 5-10%) due to the non-native sequences (e.g. remicade) and likely protein aggregates in the final formulations. If your efficacy loss is due to that, switching drugs will help.

Best,

Matt
Posted 3/16/2013 4:21 AM (GMT 0)
I think my loading doses for Remicade were: initial dose, then two weeks, then a month after the second one. Then 8 weeks regularly. I think.

My GI doctor really believes Remicade is the best medicine out there for us. It wasn't immediate for me, but cleared things up considerably within a couple months. Bleeding mostly stopped within a day or two, so that was very nice.
Posted 3/16/2013 7:32 AM (GMT 0)
I tried Remicade first. I got an infection and had to go off. I am ow on Humira. My doctor says Remicade is stronger at suppressing the immune system. He is afraid to up my dose of Humira to once a week instead of every two because it will suppress my immune system as much as Remicade.
Posted 3/16/2013 1:03 PM (GMT 0)
The typical loading schedule for Remicade is first infusion at 0 weeks, next at 2 weeks, next at 6 weeks, and then every eight weeks thereafter. (In other words, the time between the first two infusions is two weeks, then you wait four weeks, then you wait eight weeks). This isn't written in stone -- if you don't have a positive response to the first two infusions, your GI might choose to increase the dose of the next infusion and/or do it sooner. Another thing you can try if you aren't having a response to Remicade is an infliximab levels blood test -- it can be kind of pricey (my insurance co. would never give me a straight answer about whether they'd cover it or not), but it can help your GI decide if you are truly a Remicade non-responder or if you need a higher dose to reach therapeutic levels in your blood. The standard dose is 5 mg/kg but some people need up to 20 mg/kg.

I had three Remicade infusions, the first at the standard 5 mg/kg and the next two at 10 mg/kg. Never had any positive response at all, not even a minor improvement in symptoms. When people say it can take a few months for Remicade to kick in they're almost always talking about reaching remission or a significant improvement in symptoms -- if you're a responder and you're receiving the appropriate dose, you should start noticing small changes after the first couple of infusions. I wish I had known that because I waited months holding out hope when it was already clear to my GI that I was almost definitely a non-responder.
Posted 3/16/2013 1:27 PM (GMT 0)
I really don't understand the loading dose thing. If it take weeks or months for these drugs to even work in the first place then why can't you just take a normal dose for weeks or months until it starts working?
Posted 3/16/2013 2:38 PM (GMT 0)
The drug works immediately if you have a therapeutic level in your blood. That's why people who are Remicade responders will often say they feel better literally during their infusion. I suppose you might eventually reach a therapeutic level doing infusions every eight weeks with no loading doses, but I don't know anyone who needs Remicade who wouldn't like it to start working as soon as possible...
Posted 3/16/2013 2:42 PM (GMT 0)
That may be, I really don't know, but they also have "loading doses" for Humira and from what I understand it can take weeks for Humira start working. So, if that is true about Humira, what is the purpose of doing the loading dose if it is going to take weeks or months to start working anyway? I can see if it does start working immediately. That makes sense.
Posted 3/16/2013 8:00 PM (GMT 0)
I take Humira and I feel a little better day after my shot. I felt the same with Remicade.
Posted 3/16/2013 10:37 PM (GMT 0)
I had my first Remicade infusion about a week and a half ago; before that, I had only been on mesalamines and topical steroids. I also started 6MP shortly before I started Remicade, but I'm on that too boost Remicade's effectiveness, and not because it's the main drug my GI wants me to take.

I didn't feel any different during my first infusion, and afterwards, I was just exhausted. Like, I was falling asleep on the train ride home after grabbing dinner with my partner. Otherwise, no difference. Three days later (a week ago), I started feeling noticeably better, and I've maintained that improvement over the week.

Symptoms went from 10-15 completely loose/liquid BMs per day, lots of cramping, blood every other day or so, to 2-5 BMs, mostly formed, no blood, less cramping. I can also tell the difference between just gas and a real BM.

The only problem? I am starting to get a cold, and my next loading dose is on Monday! I'm hoping to get rid of it quickly so I don't have to reschedule the second infusion.

I am honestly not entirely clear on how the loading doses work, versus the regular doses every 8 weeks. I assume that it has to do with the longevity of the antibody (how long it takes to degrade) and the levels of TNF-a and the rate of TNF-a production. So some people might produce less TNF-a, or produce it at a slower rate, and they would need less Remicade per dose. And then I'd assume that the loading doses would be to sort of clear out the overload of TNF-a present in the system at the start.

Hopefully, I will be able to get my second dose on Monday and I will ask then. I know it's important not to have a dose when you have a cold, but seriously, I'd rather have a horrible cold that takes a while to go away than stay in a flare any longer than I have to! I desperately want to eat a salad.
Posted 3/17/2013 1:00 AM (GMT 0)
i'm hopeful this will help. when i found out my condition is completely diffuse and rated as severe, I realized i'm getting to the point where hospitalization will not be a choice but a requirement. humira does absolutely nothing for me, i'm angry that i've been on it so long while telling the doctor it does NOTHING.
Posted 3/17/2013 7:03 PM (GMT 0)
does anyone have an idea how much remicade infusions run? I have medco/express scripts, I looked it up on their system and apparently it says I have to pay 75 copay for it and the actual negotiated cost is around $850. I thought the stuff was 8000+ per treatment so i'm really confused.

i'm on student health insurance and it's not clear at all what the costs will be for the treatment.
Posted 3/17/2013 9:37 PM (GMT 0)
It depends how many mg of infliximab you're actually getting. Standard dose is 5 mg/kg. I believe when I was getting 5 mg/kg the cost to the insurance company was about $2000, when I got bumped up to 10 mg/kg it was $4000 (duh). Because it's an infusion a lot of insurance companies classify it as medical instead of prescription/pharmacy, so Remicade ended up being the cheapest med I ever got (NO copay!).
Posted 3/17/2013 11:59 PM (GMT 0)
I only paid a 20. Office visit fee when I was on Remicade. No idea what the insurance paid.
Posted 3/18/2013 12:11 AM (GMT 0)
My Remicade was done at the hospital infusion center. They bill my insurance $6700 per infusion. My insurance pays all but $900 of that. RemiStart pays up to $4500 per year.

The big bill is for the nurse, IV, saline, monitors, room space, bandages, and the actual medicine.

I'm currently working with the hospital billing department to get their coding acceptable to RemiStart.
Posted 3/18/2013 5:26 AM (GMT 0)
am i optimistic to think i will respond to remicade when humira has already proven to have failed?
Posted 3/18/2013 5:44 AM (GMT 0)
I haven't received a bill for my first infusion, and there was no copay when I went. I also have student insurance (Aetna), but I've been too lazy to read up on how much they said they'd cover. I figure I'll have to pay for it, however much it is, since my options are either take Remicade and pay the money, or refuse and end up dropping out of my program because of illness.
Posted 3/18/2013 2:14 PM (GMT 0)
I pay only a copay of $35, I think because I have the infusions in the doctors office. Plus about $2 for blood tests each time.
I have to watch my bills, sometimes they screw up and charge co-insurance and I have to resubmit it. That happens at least once a year!

My doc says she and other GIs observe that Remicade works better for UC than Humira.
Posted 3/29/2013 10:55 PM (GMT 0)
I got an itemized bill today.

Med/Surg Supplies
Nitro tubing IV set $34.00

IV Therapy
NS - 250ml. $50.15

Pharmacy
Filter - 1.2 micron set $14.10
Infliximab $6003.60

Oncology
IV Therapy (2 hours). $564.00

$6665.85
✚ New Topic ✚ Reply