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mesalamine not working. What's the next step?

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Ulcerative Colitis
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Posted 8/18/2015 6:58 AM (GMT 0)
I've been on Mezavent since April this year. I've never been in a remission from it not even close. Mezavent in combination with salofalk enemas has brought down the bms from 15-30 times a day to 6-10 but it's still very debilitating and getting in the way of my lifestyle. Seeing my digestive health specialist tomorrow so hopefully he will give me a new medication in combination with Mezavent. Do you guys have any idea what to do next?
Posted 8/18/2015 9:55 AM (GMT 0)
Often the next step after mesalsmine is 6mp or imuran.
However since you have good response to the mesalsmine but it's not enough they may give you skmething like cortifoam to buy you some time for the melamine to work better.
Thankfully at this point you still have several options to try
It's also possible they will switch the mesalsmine to see if that works
Posted 8/18/2015 1:14 PM (GMT 0)
Have you tried prednisone yet? If not you should. If your condition is bad the mesalamines probably just aren't good enough by themselves to put you into remission. The pred only works while you take it and you can't take it long term but it can help you heal to the point where the mesalamines can keep you in remission once the prednisone is tapered back. You just have to go into it knowing you will stop the pred, even if you get worse once tapering off. That's where everyone makes their mistake.
Posted 8/18/2015 1:26 PM (GMT 0)

garylouisville said...
Have you tried prednisone yet? If not you should. If your condition is bad the mesalamines probably just aren't good enough by themselves to put you into remission. The pred only works while you take it and you can't take it long term but it can help you heal to the point where the mesalamines can keep you in remission once the prednisone is tapered back. You just have to go into it knowing you will stop the pred, even if you get worse once tapering off. That's where everyone makes their mistake.


yes I have tried pred, it worked immediately. 1-2 bms a day. But once I got to 10mg it started not working and once I was completely off it symptoms returned as per usual in about a month
Posted 8/18/2015 1:33 PM (GMT 0)
Immunosuppressant is the typical next step.

The add Remicade for another step.

Sometimes switch to another biologic if Remicade does not work.

None of the biologics have been compared head to head, but each compared to placebo. Remicade looks to be a few percent better, but some of the newer ones were tested on folks who had already failed Remicade - so hard to tell exact remission numbers.

I am starting to slip back into low-level flare, and discussing Entyevio with my GI. It looks to work almost as good as Remicade, and it does not suppress immune system. I like that aspect.
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