30 weeks pregnant...starting Remicade next week...need positive vibes and remi stories :)

iPoop said...
Good luck on your infusion. Sounds like remicade/infliximab is a pregnancy category B drug, fairly safe, but some unknowns.

• Category A: Controlled studies show no risk or find no evidence of harm.
  
• Category B: Animal studies show no risks, but there are no controlled studies on pregnant women.
  
• Category C: Animal studies have shown risk to the fetus, there are no controlled studies in women, or studies in women and animals are not available.
  
• Category D: There is positive evidence of potential fetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (i.e. life threatening condition to mother)

-------
Pregnancy and ibd (from the resources thread)
onlinelibrary.wiley.com/doi/10.1002/ibd.20532/pdf

Biologic Therapy
Infliximab, a pregnancy category B drug, is approved for the management of CD and UC. Infliximab is an IgG1 antibody, which does not cross the placenta in the first trimester, but very efficiently crosses the placenta in the third trimester. While this protects the infant from exposure during the crucial period of. organogenesis, infliximab levels can cross easily in the third trimester and therefore be present in the infant for several months from birth. There is a growing body of evidence that suggests infliximab is low risk in pregnancy.
----
For Caitie
Immunomodulators
Azathioprine/6-Mercaptopurine/Imuran
6-Mercaptopurine (6MP) and its prodrug azathioprine (AZA/Imuran) are pregnancy category D drugs.

Well, steroids are category C, so by that logic, she's much better off on Remicade. I was on Apriso my entire pregnancy, and I'm pretty sure it's also category B. That article is from 2008, so there's been a lot of time to collect further evidence about the effects of Remicade on the baby.

Honestly, pretty much all drugs are at least category B, because there just aren't that many controlled studies on pregnant women.

Here are a couple.
http://ecco-jcc.oxfordjournals.org/content/eccojc/9/2/107.full.pdf
http://www.wjgnet.com/1007-9327/pdf/v20/i13/3495.pdf

I just scanned them, but one interesting new thing is that they're now recommending you switch from Asacol to a different 5-ASA, because of the dibutyl phthalate coating. So it's now category C instead of category B. But that's why the drug company claims they don't have Asacol anymore, and now have Delzicol, right? Or am I confused on that?

First infusion complete. No reactions during infusion. Let's hope for quick relief and positive results. Only time will tell at this point.

Thank you to everyone. Your support means so much.

TotesMagotes said...
First infusion complete. No reactions during infusion. Let's hope for quick relief and positive results. Only time will tell at this point.

Thank you to everyone. Your support means so much.

I'm glad it went well. Give remicade 2-3 infusions and you should have improvements by then.

TotesMagotes said...
First infusion complete. No reactions during infusion. Let's hope for quick relief and positive results. Only time will tell at this point.

Thank you to everyone. Your support means so much.

That's great you didn't have any reactions, and I really hope it works! I really hope you're in remission, or close to it, by the time the baby comes. I don't like saying this, because I love my son with all my heart, but the newborn period with my daughter was so much more enjoyable than it was with my son, simply because I was well. I really wish that you get to just sit back and snuggle your sweet little newborn and not worry about UC!

iPoop: Yep I knew I saw that imuran was a category D somewhere. Also read that it can cause decreased fertility as well. When I saw that I almost cried. I swear to God if this disease prevents me from having kids I'm gonna hurt someone.

Hey Totes :)

At a support group I went to a few years ago a lady came in that had been on Remicade 10+ years and was still doing excellent. She had been on it through college and as she built her adult life, if I remember right. I think (but can't remember exactly) that she was at least married, and might of had kids now.

I've had issues that led me to stopping Remi (we still don't know if it was it or something else... in process of searching for answers). But, I'm super-sensitive to meds a lot of the time. I highly doubt you'd experience what I did.

The best part of Remicade is that you really just can relax while on it. Most likely you'll get into a great remission while on it. My GI doctor told me when I was beginning it that people don't realize how bad they've been feeling until they actually get help to feel better.

I think you'll end up happy as can be. Good luck!

I love Remicade. It has made my RA bearable. Hate to miss my infusions. Best wishes to both of you. Remicade is awesome.

These stories and all the support make this so much easier to deal with. You don't realize how much other people don't understand what we go through and the choices we have to make until a bad flare and decisions like this are staring us in the face.

For those on Remicade do you use any other maintenance drugs? 5-ASAs, enemas or suppositories?

I am going to start tapering my steroids and think that the safest route it to continue with enemas/supps as I heal.

I do not plan on going off of Lialda in the near future as I hope it helps during post partum. I really hope I take to Remicade!!

@iPoop what do you mean that the enemas were harder to eliminate entirely? Symptoms crept in or the mental security?

Good to know on Lialda. I guess I am now as far up the food chain as it gets with UC meds. Lol.

TotesMagotes said...
@iPoop what do you mean that the enemas were harder to eliminate entirely? Symptoms crept in or the mental security?

Good to know on Lialda. I guess I am now as far up the food chain as it gets with UC meds. Lol.

Yes, symptom-creep/return when I dropped rowasa to less than twice a week. I tried weekly and did well for about 3 weeks, then I went from 1bm a day to 4 with a dramatic return of urgency. Did a nightly course of rowasa for 4 days, and back to normal. Returned to twice weekly for several months. Doctor said try weekly again, it's been two months at weekly now, seems fine. Holding at weekly until June then trying to quit rowasa, according to doctor.

I must've had some lingering rectal inflammation that remicade has since healed.