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Posted 6/26/2023 4:52 PM (GMT 0)
My IBD nurse made an interesting comment today....biologics and small molecule therapy are excellent at being preventative of flares occurring rather than being necessarily meant to cure a flare....i never thought about things that way...i think shes hinting that for most bad flares you might still need some steroid therapy to get the thing under control and the biologic is designed more to keep the thing under control

any comments or opinions on this?
Posted 6/26/2023 5:39 PM (GMT 0)
I think this is a universal truth among all GI doctors and nurses. It’s why most doctors must prescribe steroids for a flare and why you get a maintenance medication to start during the flare. Still waiting on new treatments besides steroids though since they are so detrimental in every way possible.
Posted 6/26/2023 6:51 PM (GMT 0)
That's an interesting way to look at it. I think one of the advantages of biologics is that you can stop taking them if needed and restart when things are better. I am on Rinvoq and currently having a small flare after a year of remission. We will see what happens next, I have a feeling prednisone will be involved.
Bacon girl, it's interesting they didn't stop your Rinvoq when giving you a high dose of steroids, I am learning as I go.
Best to you!
Posted 6/26/2023 7:33 PM (GMT 0)
BeatUC what happened was I started rinvoq but it wasn't working at all so I started budesonide. That also did not work so I deteriorated for a few weeks and then got admitted on iv steroids for a week. You typically dont stop the maintenance med at the beginning of starting it unless it is making you really sick. They never mentioned me stopping it while being treated with tv steroids. The whole point is to have the maintenance med build up in your system by the time you stop steroids (in an ideal world haha). The real test is being on the med without steroids which is always such a gamble.
Posted 6/26/2023 7:55 PM (GMT 0)
That was an interesting statement.

My GI doesn't prescribe steroids unless he has to.. so sometimes when I flare I just watch what I eat, get alot of rest and sometimes the next Remicade infusion helps and I slowly recover.... But sometimes he prescribed them right away. I've got to ask why that is..

Clo
Posted 6/26/2023 7:55 PM (GMT 0)
Just my personal experience: I feel that entyvio did heal my flare and my UC. I was on prednisone when I started my infusions but was able to taper off it for the first time in over a year. I’d tried getting off prednisone several times in that year but symptoms always returned after 20 mg. I never felt that pred cured my flare, it only tamped down symptoms. Cure didn’t happen for me until entyvio
Posted 6/26/2023 8:06 PM (GMT 0)

Charlie789 said...
My IBD nurse made an interesting comment today....biologics and small molecule therapy are excellent at being preventative of flares occurring rather than being necessarily meant to cure a flare....i never thought about things that way...i think shes hinting that for most bad flares you might still need some steroid therapy to get the thing under control and the biologic is designed more to keep the thing under control

any comments or opinions on this?

Steroids can be needed if you have a very low quality of life until the biologic kicks in, but some people who aren't flaring badly can just go on a biologic and can skip the 'roids.
Posted 6/26/2023 8:06 PM (GMT 0)
I think everyone with moderate/severe disease has ups and downs even while on treatment, and those ups and downs often require steroids. As much as there is some truth to her comment, I've also seen A LOT of people respond to biologics as rescue medication. There are people here, on HW, who were in bad flares that got better nearly overnight with Remicade. I am sure people have had similar results with a variety of medications. I personally never saw much result with any of the meds - even with the addition of steroids. Some of us are refractory I suppose. Hopefully, new meds give people more options.
Posted 6/26/2023 8:12 PM (GMT 0)

beatUC said...
That's an interesting way to look at it. I think one of the advantages of biologics is that you can stop taking them if needed and restart when things are better. I am on Rinvoq and currently having a small flare after a year of remission. We will see what happens next, I have a feeling prednisone will be involved.
Bacon girl, it's interesting they didn't stop your Rinvoq when giving you a high dose of steroids, I am learning as I go.
Best to you!

I am not sure what you mean by that. Stopping and starting biologics can sometimes create antibodies and the med won't work when you start it again. The only time you should stop a biologic is if you have some sort of other medical condition that a doctor doesn't want you on the med. For example, some surgeons want you off of biologics before major surgery. You can take pred while on a biologic or one of the jak inhibitors.
Posted 6/26/2023 8:30 PM (GMT 0)
When my doc started me on Rinvoq, he said one of the advantages was that you can stop it anytime and restart with no issues. Rinvoq is a jak inhibitor but is also considered a biologic. It can be stopped if you have an infection for instance, so your body can fight the infection with your immune system at full strength. As I understand it, antibodies are not an issue with jak inhibitors but these meds are so new to me, I'm really not sure. I'm also not sure how prednisone, mesalamine and many other UC meds interact with jak inhibitors or if they are even necessary anymore.
Posted 6/28/2023 2:15 AM (GMT 0)
I disagree with her comment. I was steroid-dependant for years until Xeljanz.
Posted 6/30/2023 7:50 AM (GMT 0)
I think this is not true. I was not on steroids when I started xeljanz. In fact the only other drug I was taking was oral mesalazine. If you treat the mechanism which is causing your flare, your flare will stop.
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