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How can Entyvio not work?

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Ulcerative Colitis
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Posted 10/27/2017 12:10 AM (GMT 0)
Weird question, but I'm curious - if Entyvio isn't working, does that mean it isn't doing what it's supposed to (messing about with white blood cells or whatever it does), or does that mean that it is doing what it's supposed to and the white blood cells are being messed around with, but that's not having the desired effect on the illness for some reason?

(Can't remember if it's white blood cells or whatever it is, but you catch my drift anyway I hope!)

By the way I have been flaring for I think years now, 2 or 3...it's weird because the symptoms are manageable in terms of my life, and my general health seems fine (like I feel good and look fine) but I'm still absolutely not right and have definite symptoms day by day, and that can't be good can it?
Posted 10/27/2017 12:19 AM (GMT 0)
it could be either it is not hitting the theraputic target ( integrin α₄β₇) or it is, but the amount of binding it is doing is insufficient compared to the amount of integrin α₄β₇ upregulating inflammation.

if not hitting target, it could be because you are metabolizing it too quickly and it is not staying in you system long enough, or because you have developed antibodies against it.

if it is insufficient, a higher dose might help, as long as there is no toxicity concern. or, some agent to increase the binding action could may be added - but I have not heard of one.

does this make sense?
Posted 10/27/2017 12:21 AM (GMT 0)
We have a poor response to the drug I guess. I was a non-responder to nearly everything.
Posted 10/27/2017 12:22 AM (GMT 0)
It could mean you have developed antibodies to entyvio. It could mean that you run out of entyvio too quickly. There's a report from Prometheus labs for entyvio to answer those questions.

It could mean that your immune system has found a way to work around entyvio.

I'm more famiar with remicade and will use this as an example. Remicade blocks Tnf-alpha an immune signalling protein that says "hey send an attack and inflammation over here". In some it works brilliantly. In others it has limited or no affect. Why? Some people's immune systems use more than just tnf-alpha for that battle cry, other proteins also signal an attack. Remucade only blocks tnf-alpha, and the battle cry is atill heard and fulfilled. So, the immune system has a way around it for some. Enyvio should be similar but with different proteins of course.
Posted 10/27/2017 12:26 AM (GMT 0)
Seems like, at least with the TNF inhibitor biologics, some bodies just don't respond to the medicine and it doesn't have as much effect on them. Often switching to another TNF inhibitor will do the trick. I read an article on anti-TNF biologics used in RA recently and they said that 30-40% of patients fail their first biologic, but will respond to another one in the same class.

In the future, more Entyvio-type drugs will probably appear and will give more options for patients who fail Entyvio (though I haven't heard of too many, honestly... seems to have a pretty decent success rate).

What kind of symptoms are you having? For some people, having UC means that some symptoms never go away even after complete mucosal healing because of functional issues or something off-balance that can't be seen. Sometimes the symptoms aren't UC at all... your Entyvio won't heal your hemorrhoids or a case of GERD, for instance. You've been flaring for awhile so it might take a long time for things to settle.

I don't know enough about Entyvio to know if mesalamine or Imuran/6mp is ever used in conjunction with it, but sometimes patients on biologics need a boost from another medicine class to fully bring things down.

Glad your general health is fine... even when I'm flaring, you'd never know by looking at me. I find that life with UC is easiest when I keep a tight handle on all of my other health variables and strive to lead a healthy lifestyle as best I can.
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