Failed Humira, and now Remicade, what’s next?

Hi everyone,

I’ve finally come to terms that Remicade is no longer working for me. I am on the highest dose every 4 weeks so I cannot bump it any higher. It worked decently for 2 years but I never experienced true remission. It made me “comfortable” but I still had inflammation, diarrhea and cramping even on my better days. I tried humira before and saw no improvements. I’ve been flaring lightly for the last 8 years almost.

I have severe pan colitis. I am allergic to all mesalamines and they worsened symptoms significantly.
I have tried mercaptopurine but every time i use them I don’t see any improvements and they cause my liver enzymes to skyrocket and doctor is too afraid to put me back on them yet.
I am also steroid resistant (prednisone and Uceris) so they do little to curb a flare.


Which medication would you try next? I am currently experiencing UC symptoms but I’m not in a full blown flare. As soon as I’m off the Remicade for more than a week I begin to flare horribly. Something that is fast acting would be preferred.
My doctor has mentioned Stelara and Entyvio.
I’ve also heard of Xeljanz and Cimzia?

Based on me seeing a little improvement with the remicade, is there one medication you would try first over another?

I’d would appreciate any insight.

Any suggestions for starting the diet, and do you have any meal plan suggestions?

I have tried SCD in the past as well as another that I cannot think of the name but I didn’t see results with either. I do try and avoid sugary, high fat, processed foods, but I can’t say I’m perfect... it was definitely harder to stick with the diet when I didn’t see results.

Thank you for your thoughts!

I think the doc is leaning towards Entyvio or Stelara. However I’d love to have the freedom of pills that Xeljanz offers.

Is anyone aware which of these is the fastest acting drug ?

Xeljanz started working for me within two days and that was two years ago.
I even went off it for 3 weeks when I had a knee replacement and stayed controlled for the first two weeks.

They do have an assistance program, check out their website. I believe they have a phone number you can call & talk to someone & they can check your insurance coverage.

Here is the number to call; 1-844-935-5269

Hmm well, I'm a female of child bearing age, and I've been taking xeljanz for 2 years. I would guess the risk factor is blood clots, which has been demonstrated for arthritis patients over 50 with comorbidities taking xeljanz at a high dose, and not yet established in UC patients (who mostly only take the high dose during the first 2-4 months to induce remission). My GI isn't keen on me taking birth control pill as that can be an added risk factor for thrombosis but I'm also skinny and very active physically. Noone mentioned any risks related to pregnancy and it certainly wasn't a consideration when i was choosing between xeljanz and entyvio. Also, flaring while pregnant is far more risky.

Interesting! I’ll have to ask about the Xeljanz again and why they wanted to use that as a last resort. I actually mentioned it first because I thought the freedom of pills and fasting acting nature would be beneficial for me. I don’t mind the infusions but they are kinda a pain to schedule with work.


And yes I have heard of care credit. I will do it if I have no other choice. I just really hate having to put myself in debt to manage my illness. Not fun at all 😔.

My husband has been on Xeljanz almost 5 years. It was the game changer. The nice thing was that within two weeks he could tell that it was working. He has been in full remission since Oct 2016. We are very fortunate to have insurance that covers it. I joke that it’s the most valuable thing in our house. Good luck.