Humira to remicade?

I have been on Humira since November 2018. Initially it seemed like I was getting response with the loading doses but things have slowly deteriorated. I had the Humra levels checked and while no antibodies the serum levels were extremely low (my level is 1.2 and therapeutic level is 4.9-6.5). The dr changed me to weekly dosing (this week will be week 2). Things have deteriorated so much that I am back on pred

Has anyone successfully moved from Humira to Remicade? I know they are similar drugs, but remicade dosing is weight based rather than the same for everyone. I had been resistant to remi because of that (I am very overweight so would be on a high dose), but perhaps that is what I need if Humira weekly dosing doesn't work.

I have been flaring for over a year and want the best shot at getting this to end. This week I have not been able to work because frequency and urgency is so high. Just did stool tests yesterday to make sure nothing else is going on, awaiting results.

Thanks in advance for your thoughts.

There are Cimzia and Simponi that are anti-TNF shots not based upon weight.

Xeljanz is also not weight based (not 100% on that).

Stelara is weightbased.

Remicade is a well studied drug that is relatively old. It was one of the first biologicals developed in the 90’s.

Remicade worked best for me out of all of the anti-tnf meds.

Have you considered rectals until you decide upon your next medication?

Keith -- I have been on steroid enemas since July. Since they aren't keeping me relatively stable anymore the past week I have started alternating them with mesalamine enemas in the goal of getting off the steroid ones. Been on them too long. Thanks for the drug info!

John -- that was kinda my thinking too.

I am hoping that someone here might have an experience to share.

My brother started on Simponi (lots of similarities to Humira), got a good response after the loading doses, then the response faded some a few months later.

We guessed that his levels weren't high enough, but insurance wouldn't cover higher or more frequent doses. They would cover Remicade, so he switched to that and is responding very well.

me . I switched from Humira -that worked for a very short time to Remicade- I like that the Remicade dose can be adjusted- it's the best part of the drug. I am doing much better on Remicade so its worth trying it for sure.

Thanks, Countess!

My current GI is suggesting Stelara. He didn't talk to me about it and I don't really hear of many people here on it except for those with Crohn's. Seems like a longshot to me. I am long overdue to switch to a new GI. Last straw was when he prescribed the pred on Monday AM but his office staff was too busy to call the script in until Tuesday.

As of 2/19 I am switching to a new GI. By then I should know if the increased dose is working so will discuss with the new GI.

The idea of something working within a few days is very appealing, Keith. Did that work for you prior to your surgery or just for the pouchitis? Stelara hasn't been approved for UC yet and I don't have a definitive diagnosis as to whether it's UC or Crohn's (Scope in June seemed to be leaning more towards UC) so it would likely be a battle with insurance and more delays in getting a treatment that works.

I don't have a lot of faith in my current GI. He didn't even know that there was a blood test to check Entyvio levels until I told him and insisted on getting it checked so that the dosage could be increased last March. It still took me until July to convince them to do the test. I really feel like the bad flare now is related to that 4 month delay in modifying treatment. I just kept getting worse. Not saying that the increase of Entyvio would have worked or that Humira would be working better. But I am saying that I don't think I would be this bad now and at the very least I could already be on a med that works better for me.

I am on day 7 of 40 mg of pred and had my 2nd weekly Humira shot. So far the only improvement is a little less blood. Hoping something kicks in soon!

CCinPA said...
The idea of something working within a few days is very appealing, Keith. Did that work for you prior to your surgery or just for the pouchitis? Stelara hasn't been approved for UC yet and I don't have a definitive diagnosis as to whether it's UC or Crohn's (Scope in June seemed to be leaning more towards UC) so it would likely be a battle with insurance and more delays in getting a treatment that works.

I don't have a lot of faith in my current GI. He didn't even know that there was a blood test to check Entyvio levels until I told him and insisted on getting it checked so that the dosage could be increased last March. It still took me until July to convince them to do the test. I really feel like the bad flare now is related to that 4 month delay in modifying treatment. I just kept getting worse. Not saying that the increase of Entyvio would have worked or that Humira would be working better. But I am saying that I don't think I would be this bad now and at the very least I could already be on a med that works better for me.

Sorry if I wasn't clear. I had to stop Stelara for 6 month due to surgery for my hip replacement (thanks Prednisone) and NOT for my j-pouch surgeries. I started Stelara about 10 months prior to my hip surgery.

There is no drug FDA approved for pouchitis; it is all off-label. I started Stelara for the pouchitis. If you failed Humira and Entyvio then you have a good case to move on to Stelara. If your GI is offering to do the leg work then I'd consider taking your GI up on the offer.

I have two GIs (one is my primary care doc) and they both are down on entyvio's effectiveness. One said "if it works" like he hasn't had much success with Entyvio. My IBD specialist GI raves about Stelara and has all these stories that he tells about his patients that are currently on it. He just recently did the scope on my pouch and was very impressed with it. I recently had a thread about j-pouch scope.

I did the Prometheus test for Stelara and my GI and his office didn't how Prometheus' new patient assistance system worked if my insurance company rejected the $2,500 claim. I'm still fighting it out.

I loved Entyvio. Wish it hadn't stopped working. And it did work really well for over a year -- complete remission confirmed by scope.I'll always wonder if it would have kicked back in if my dr hadn't delayed checking the levels for 4 months. I think by then the flare was too bad and my levels were so low I probably should have gone through loading doses again.

Will be talking about all of this with the new GI next week.