Started Remicade after Humira

Friday was my first loading dose of Remicade. Everything went well with the infusion, no pre-meds and I had no side effects. It will be a while until I can tell if it's going to work since I am still on 40mg of pred.

Things went really south for me in February after I was switched to weekly shots of Humira (lots of blood, 10-15x/day all diarrhea, urgency) and after not being able to get a bed at the hospital for IV steroids (I would have had to "board" in the ER and there was no way i was doing that) the doc tried me on 60 mg of pred which was a miracle worker. I've been tapering 5 mg every 5 days and look forward to getting off of it (side effects of elevated blood pressure, severe muscle weakness, and my blood glucose is so high that I am now in the diabetes category -- I think PCP is going to want me to be on meds for that).

I had a 2nd Humira level check after I was on weekly dosing a month. Prior to the increased dose the levels were low (1.6) but no antibodies. The 2nd check the levels were slightly higher (2.1) but still far too low. But what shocked me was that I had high antibodies (30 with optimal being less than 10).

Does that mean that I may also develop antibodies to Remicade? Will the prednisone help prevent that for now? I can't take azathioprine (high LFTs) so not sure what I could do lower the chances of the antibodies.

Feeling good right now with the UC ... stools are always formed, no urgency, haven't seen visible blood for over a week, 3-4 BMs/day -- almost back to normal. I want this to continue for years!!!

There's no guarantee your immune system will figure out how to create antibodies to remicade. Remicade and humira are different enough in molecular structure that the immune system must try all over from scratch on how to develop antibodies to it. It may not succeed this time.

Yes, prednisone should help limit the immune system's ability to figure out antibodies. Initial exposure is when the immune system is very aggressive in attempting antibodies, and pred is a broad immune suppressor and limits that activity.

Not sure on a direct-affect, as I haven't squeaked yet, and I still despise plain cheese lol.

For those curious what the heck we're talking about:

Partly human antibodies are called ‘chimeric’ antibodies. Remicade (infliximab) is a chimeric antibody, made from a mouse cell lineage that have been genetically engineered to make human-like antibody proteins. The resulting antibody administered to us is about 30% murine (mouse) and 70% human in molecular content. A pretty meaningless fact in most regards.

Humira (adalimumab) is a fully human antibody, but it is made using a Chinese hamster cell lineage. In this case the researchers have been able to design a genetic sequence that makes a fully human antibody, without using any DNA from the hamster cell itself in the sequence.

Source: http://blog.crohnology.com/2015/10/08/how-biologic-drugs-are-made/

Oh! I was trying to find the post where someone was trying to communicate with a mouse... It gave me my chuckle for the day! I wanted to know how it turned out. Seems like it might have worked, well done!

maybe coincidence or maybe we are the beginning of the Planet if the Mice lol

Briefly heard the mouse this AM and had another chat with him. Hopefully he will listen this time ;)

I got a message from my docs office to make an appt next week to discuss starting 6 MP to prevent antibodies. I'm a little nervous about starting that while I am am still on pred along with the remicade. Seems like a triple whammy to my immune system. Plus I've had 2 iron infusions and a blood transfusion in the past 5 months along with high blood sugar now. Will ask for at least weekly testing since I previously had issues with Azathioprine

Glad you're doing well