Humira vs Remicade?

Any thoughts on this. I'm at the point where my doctor said these are my options and that the only difference is how it is received and cost. But that it's basically the same drug.

Anyone have experiences that make them prefer one over the other?

I'm leaning towards Humira-- I'm not worried about the injection (although it's unpleasant), I'm mostly concerned about side effects and effectiveness. I'm currently on Lialda and Prednisone for a mild flare (not helping) so, as my doctor put it, as my disease evolves so must my medication. She also said that without one of these medications, the risk for my UC to become far worse is much higher than the risk of TB or certain cancers with these new meds. Which makes sense.

Anyways, any insight is appreciated. Thanks.

There is some evidence that Remicade is works for a few percent more people, but there have not been a lot of studies to compare them head to head.

With Remicade there is more chance of forming antibodies that reject the drug, so that is a plus for Humira.

Determine if you insurance wants one tried before the other. I think there are some companies requireing Remicade to be failed before Humira because Humira is newer and Remicade has more evidence. But, I think there are other cmpanie that want injections tried and failed before the pay for infusions. Go figure.

So what does your insurance say? Do they say you can choose either?

I think Remicade works slightly faster than Humira. Humira takes between 3-6 weeks to kick in, sometimes longer, whereas for some people Remicade can show a result quite quickly.

I am on Humira and I love that I can inject myself at home, I don't use the pen, I use the syringe, and inject into my stomach, and I can honestly say it is painless. I started taking it on the 13th of July and every week I have seen a gradual improvement in my Poops.

I also feel okay too, apart from the occasional angry flare-up which is from the Prednisone...my point is that it has not changed who I am..I was always fearful that it might make me feel depressed or anxious.

I am on Humira and like the convenience of it and in my case because my better half is a nurse she gives me my shots which in my case are every week.
I have a friend who's 26 year old son has UC and has started on remicade and he has a problem with swelling of the face which has made him look older than his age.
But then we are all different as to how meds are tolerated by our bodies.

Insurance companies often will want you to try imuran first, because it has been available much longer and is much, much less expensive than Remicade or Humira (or any of the other biologics).

But if your disease is pretty severely active, you might be able to get approval for a biologic without having to give imuran a try first. The thing with imuran is that it can take several months to kick in fully, so it's only worth trying first (and by itself) if you have several months to wait and see, ie, if your disease isn't terrible right now.

Imuran is modestly effective, statistically speaking - perhaps better than mesalamines like Asacol, but not nearly as effective as the biologics. It requires frequent blood tests, especially in the first few months.

Remicade, Humira, and other biologics (Entyvio is becoming very popular for UC treatment) are much more expensive, but they're generally more effective (not for everybody, but statistically speaking again).

As to which biologic to choose, it will depend on which your insurance will approve. There haven't been any head-to-head comparisons to see which one is best (some comparison studies might be ongoing right now, but results won't be out for a couple years at the soonest).

Remicade and Humira both have the same method of action, and, theoretically, should be equally effective. But in reality that's not quite true. Humira is self-injected, while Remicade requires going in every few weeks for a few hours for an infusion directly into the bloodstream. Because of that, Remicade dosing is easier to adjust and control, and it *seems* to be *slightly* more effective than Humira, because the medicine being infused gets to the tissue better than with Humira, which has to go from the injection site, into the bloodstream, and then to the tissue (colon).

Entyvio can take a little longer to work than Remi or Humira (but probably quicker than imuran), but its side effect profile & risks might be a little better than Remi or Humira.

Side effects vary from person to person, but overall are pretty similar between imuran and the biologics - mostly increased risk of infection, a small increased risk of lymphoma, and rare cases of liver or pancreas issues or other reactions.

The most effective treatment to date is actually the combination of imuran plus a biologic. Statistically, this is a little better than a biologic alone. Perhaps more importantly, being in imuran along with a biologic significantly reduces one's odds of developing antibodies to the biologic - meaning better odds of being able to stay on the biologic successfully for a longer time.

So, if you're miserable with severe disease, jump straight to a biologic PLUS imuran. If you're doing semi-ok but not great and have time to give imuran a chance, start on it and see how it goes. Add a biologic if you worsen or show no improvement in the next few months.

Thanks a lot beave for your response! Appreciate you taking the time to go through that in detail...very helpful. Amazing how little I seem to know about this disease despite extensive reading. The constant I hear about bioglogics is how new they are and therefor their long term affects are yet not well known.

@iPoop, thanks for your comments as well. I suppose Remi/Humira are also in the Immunomodulators category? I've read a lot about the higher risk of lymphoma from all drugs in this category (Imuran included), but I had also assumed these were meant to be life-long solutions. In other words, how would one wean off these without regressing to square one? Is it the idea that the tissue heals in the meantime?

Thanks!