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Entyvio and Imuran

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Ulcerative Colitis
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Posted 9/8/2017 1:24 AM (GMT 0)
Does anyone out there have experience taking both Imuran and Entyvio at the same time?

I had a mild flare in Feb\March 2017 that was able to get under control with a few weeks of pred and nightly Rowasa. Since then I've been slowly slowly tapering down from the nightly Rowasa. Out of nowhere, severe flare symptoms started a couple weeks ago. Went back to nightly Rowasa, GI scheduled emergency scope. He found first 20cm healing and in good shape, but beyond that active/severe inflammation.

We re-started Imuran today, which I was on for years with no issue. Assuming my insurance company approves, he also wants me to give the go ahead to start Entyvio. His thought is to do Imuran and Entyvio concurrently, then drop Imuran when Entyvio kicks in.

Anyone have this course of therapy? Success, suggestions, side effect considerations? I'm just starting to research Entyvio. Curious how they'd determine whether Entyvio or Imuran is working if on both at the same time?

Thanks in advance for your input!
Posted 9/8/2017 5:47 AM (GMT 0)
Have you been on Remicade or Humira before? Usually one of those is tried before Entyvio (because of their longer history, more insurance companies will cover them first and only cover Entyvio if you fail Remicade and/or Humira).

There is data that imuran plus Remicade or Humira is slightly better than Remi/Humira alone, plus the imuran reduces your chances of developing antibodies.

I'm not sure about the data for imuran with Entyvio though. I haven't seen lots of data for that. It might be a good combo, or it might be unnecessary. I don't know.
Posted 9/8/2017 8:24 AM (GMT 0)
I've never been on Remixade or Humira. My GI is of the belief Entyvio is safer than those two, and Imuran, so has started to go this route if he can get insurance approval.
Posted 9/8/2017 9:43 AM (GMT 0)
Seems dine to me. Imuran is an effective UC medication on its own and therefore should help improve your symptoms in parallel to entyvio. Slight chance imuran will help prevent antibodies to entyvio like it does for other biologics but that has never been studied for this med.
Posted 9/9/2017 2:41 AM (GMT 0)
I've had my 5th entyvio infusion and believe I am in symptomatic remission (colonoscopy next week will tell if I'm in clinical remission). I couldn't take Imuran/6mp type drugs, but I was on methotrexate for a while with the entyvio, but then my GI said the studies don't prove that MTX helps any at all with entyvio, so we stopped it. I believe the same applies with imuran/6mp, but I won't swear to it. I don't *think* you develop antibodies to entyvio. I think the mechanism is different from remicade.
Posted 9/9/2017 12:31 PM (GMT 0)
Any protein released into your blood can spur your immune system to create antibodies. You are correct there's been no research into it yet for entyvio specifically. Some gasteroenterologists treat all biologics the same in that regard.

Infact, there's now an antibody and concentration test for entyvio. It's usually initial exposure to a protein that your immune system responds with antibodies. Since you initially started with MTX you're likely fine and free of antibodies. Continued use of MTX may not provide much extra protection. Nothing is known for certain though *shrug*. Let's call them educated guesses.
Posted 9/9/2017 4:10 PM (GMT 0)
@ Flowergirl - any side effects or is it going good so far? Hope you get good results on your scope!
Posted 9/9/2017 6:37 PM (GMT 0)
@ipoop-good to know there's now an antibody test.

@irish - absolutely no side effects. I do still tire easily but impossible to tell at this stage whether its the entyvio or my body still recovering. At any rate, not nearly as bad as it was. All that said, wouldn't you know the colon decided to act up today? Nothing major just that irritability which could be from all the sugar and chocolate I've had lately. Will go back to my canasa tonight which I haven't been using.

Hope entyvio works well for you too!!.!
Posted 9/9/2017 7:51 PM (GMT 0)
Interesting info on the antibody test. I believe the only prelim labs they ran on me for Entyvio was the Hep B panel. Everything was clear, except, they figured out I have no immunity to Hep B. Now my GI and PCP are trying to get on the same page in terms of timing of Hep B vaccine. PCP wants to wait until off steroids a few months to ensure vaccine will be effective. GI had his office get the latest guidelines from CDC on immune suppressed patients and vaccines. That research, based on current dose and duration of steroids, seems to indicate it's ok to start it. GI's latest proposal is to do first shot of Hep b vaccine (it's a 3 part series over 6 months)and then start Entyvio. We'll see what they land on.
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