Understanding antibodies..

my dr called with my remicade Prometheus results today. One day before my infusion I showed some antibodies and a decrease in remicade levels. I haven't received exact numbers yet.

My last treatment was the first one backed up to 6 weeks versus the 8 week. He wants to see how I react to 6 weeks, then after my colonoscopy next month start me on Imuran and play with dosage or frequency if needed.

Can you have low levels of antibodies and still have remicade work? Can it be reversed with imuran, or do you simply just stop building more antibodies?

I understand the basics of antibodies but maybe someone can explain I to me a bit better.

Oddly, I feel pretty darn good. No urgency, no blood and very solid poo. But usually around week 5 I slip a bit. So the test results were a blow to my optimism. It has me questioning every cramp, bm, etc.

Antibodies at low levels make remicade less effective, and they make it more likely you'll have a reaction during the infusion itself or within 48 hours after the infusion. Low levels of antibodies can be countered by either a stronger dose or more frequent dosing of your remicade (up to 10mgs per kilogram, every 4 weeks). Once you've got antibodies that cannot be undone, Imuran won't undue it. Imuran is a uc medication that works in a different way, it might either improve your current symptoms or be a precaution that's there to help should remicade stop working.

I'd get the Prometheus test done again later (6 months, a year...) to make sure your antibody levels don't increase and also to verify your remi concentration doesn't decrease. If antibodies continue to increase over time, you might want to switch to humira, simponi, or entvyio. Keep an eye on it.