Why do meds stop working?

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73monte
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Date Joined Mar 2007
Total Posts : 1497
   Posted 10/5/2009 8:54 AM (GMT -7)   
Does anyone have an idea if some Crohn's medications are expected to stop working after a periiod of time? My daughter seems to be responding well to Imuran, but I was wondering if there is a certain time frame where perhaps one should expect the effectiveness to diminish. I understand with Remicade, you can build up antibodies, but why would other meds just stop working. If this is the case, is there a medical reason, or is it a mystery?
 
Thanks,
Tom.
My daughter was diagnosed Feb. 19/07, (13 yrs. old at time of diagnosis), with Crohn's of the Terminal Illium. Has used Prednisone and Pentasa. Started Imuran (02/09), had an abdominal abscess (12/08). 2cm of Stricture.


ZenaWP
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Date Joined Aug 2007
Total Posts : 884
   Posted 10/5/2009 9:16 AM (GMT -7)   

Everyone is going to be different, but I've always had a problem with meds becoming less effective after about a year.  For about 10 years, I've had to switch back and forth on acid reflux meds because they only seem to work for about a year and then stop.  I was on Remicade and lost response and had to stop it (due to allergic reactions) after about a year (starting losing response before a year...maybe 6 months in), Humira seemed to lose effectiveness after less than a year and I just switched back to Cimzia.

I don't know the technical (or physical) reasons for it, but I think your body just gets used to it over time and so it doesn't work as well.  My husband has a bad back and has the same problem with pain meds....after being on one for 6 months or so, it stops helping, so he switches to something else.  He can switch back to the one that stopped helping and it will work again.   


Crohn's Disease, Acid Reflux/Gastritis, Hashimoto's Thyroiditis, Endometriosis, Arthritis, Depression/Anxiety.  Too many meds to list them all.  =) 


Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted 10/5/2009 9:17 AM (GMT -7)   
On the drugs like Imuran/6mp most folks who have success on these meds tend to be able to stay on them longer than the other meds. I believe we have members who have been on these drugs for over 10 years and have been able to stay in remission.

On the biologics it does seem that they build up antibodies to them. Some sooner, some later than others.

Hope that helps.
Gail*Nanners* Co-Moderator for Crohns Disease and Anxiety/Panic Forum
Crohn's Disease for over 33 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, Calcium  w/Vit D, and Xanax as needed. Resections in 2002 and 2005. Also diagnosed with Fibromyalgia, Osteoarthritis, and Anxiety. Currently my Crohns is in remission, but my joints are going crazy!
It's scary when you start making the same noises As your coffee maker.
*Every tomorrow has two handles.  We can take hold of it by the handle of anxiety, or by the handle of faith"*

pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20576
   Posted 10/5/2009 12:29 PM (GMT -7)   
Personally I think alot has to do with the fact that the disease has more control (a mind of it's own) than docs/researchers give it credit and I think that's the main reason why meds tend to stop working, just like the people that say they were med free and in remission for yrs, the disease has more control than we think it does.


:)
bee propolis caps 500mg one cap twice/day
omegas 369 caps one cap twice/day
probiotics 10 billion cfu once/day
vitamins C-calcium ascorbate (easy on the gut) and vitamin A each once/day
Prodiem fibre supplement one cap before bed
I've also altered my diet (no junky stuff at all, processed, fast-foods, refined sugars, ect) and exercise regularly.
I went from 30+ bloody BM's/day with lots of lower back pain to an average of 5/day no bleeding no back pain and completely formed stools, still have severe urgency issues.
~~~~~~~~My bum is broken....there's a big crack down the middle of it! LOL :)~~~~~~~~


gemini kiwi
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Date Joined Nov 2006
Total Posts : 1136
   Posted 10/5/2009 12:33 PM (GMT -7)   
This was in my inbox this morning an article about why meds stop working you may find it interesting .
Your Digestive Health [YourDigestiveHealth@EverydayHealth.com]
tess

gemini kiwi
Veteran Member


Date Joined Nov 2006
Total Posts : 1136
   Posted 10/5/2009 12:34 PM (GMT -7)   
sorry I think i did the link wrong, this may work
http://www.everydayhealth.com/crohns-disease/when-crohns-medication-stops-working.aspx?xid=nl_EverydayHealthDigestiveHealth_20091005

Post Edited By Moderator (Nanners) : 10/5/2009 2:45:42 PM (GMT-6)


LMills
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Date Joined Apr 2008
Total Posts : 1753
   Posted 10/5/2009 2:25 PM (GMT -7)   
Interesting article! The only thing I disagree on is 'if new meds don't start working within a few weeks it may be time to start looking for others.'
Mine took a little while before anything beneficial happened. They actually made things worse initially :/ Point being, don't give up if at first it doesn't seem to be working. That's a lot of damage to be undone..
Diagnosed with Crohn's in May of 2008.
Currently taking: Prednisone, pentasa, omeprazole, and humira. Using probiotics and a multivitamin.
bonniegriffith.blogspot.com/
Learning how to live again.
"He who has a why to live for can bear with almost any how."


73monte
Veteran Member


Date Joined Mar 2007
Total Posts : 1497
   Posted 10/5/2009 2:34 PM (GMT -7)   

Thanks for the replies. PB4 raises an interesting point. Does one attain remission because the meds are working, or does the disease itself choose it's own course? That would make quite a study.

Tom. 

 


My daughter was diagnosed Feb. 19/07, (13 yrs. old at time of diagnosis), with Crohn's of the Terminal Illium. Has used Prednisone and Pentasa. Started Imuran (02/09), had an abdominal abscess (12/08). 2cm of Stricture.


pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20576
   Posted 10/5/2009 2:47 PM (GMT -7)   
My opinion stated is above is based on researchers finding a cluster of at least 9 different genes related to IBD that contribute to the development of IBD and define the severity and behavior of the disease over time...disease activity/behavior varies individually for each patient and even each flare.


This particular research showed scientists that some of these genes encode factors involved in recognition and defense against bacteria as well as mutations in immune response genes which may adversely affect how the immune system reacts to harmless bacteria which they believe probably contributes to the development of IBD.


:)
bee propolis caps 500mg one cap twice/day
omegas 369 caps one cap twice/day
probiotics 10 billion cfu once/day
vitamins C-calcium ascorbate (easy on the gut) and vitamin A each once/day
Prodiem fibre supplement one cap before bed
I've also altered my diet (no junky stuff at all, processed, fast-foods, refined sugars, ect) and exercise regularly.
I went from 30+ bloody BM's/day with lots of lower back pain to an average of 5/day no bleeding no back pain and completely formed stools, still have severe urgency issues.
~~~~~~~~My bum is broken....there's a big crack down the middle of it! LOL :)~~~~~~~~


FitzyK23
Veteran Member


Date Joined May 2005
Total Posts : 4219
   Posted 10/5/2009 6:09 PM (GMT -7)   
I have severe acid reflux. The PPI's will work about 7 years for me and then I have to try a new one. My body just adapts to it.
27 Year old married female lawyer.  Diagnosed w/ CD 5 years ago, IBS for over 10 years before that, which was probably the CD. I am sort of lactose intollerant but can handle anything cultured and do well w/ lactose pills and lactaid. For Crohns I am currently on Pentasa 4 pills/4x day and hysociamine prn. I also have bad acid reflux and have been on PPI's since age 13. I have been through prilosec, prevacid, and nexium. Currently I am on Protonix in the morning and Zantac at night.  I take xanax prn for situational anxiety (aka no easy bathroom access). 


Illini
Regular Member


Date Joined Dec 2007
Total Posts : 298
   Posted 10/6/2009 6:21 AM (GMT -7)   
Does one attain remission because the meds are working, or does the disease itself choose it's own course? That would make quite a study.

The disease does choose its own course, to a degree. That is why every (respectable) study has a placebo. From what I have looked at, improvement/remission rate for the placebo group in Crohn's is around 20-30%. So that percent of the time, people get better with no intervention. But you can never know if you would.
July 2007 Drug-Induced Liver Injury
January 2008 Crohn's Ileitis
Currently trying... Enteral Nutrition, VSL#3, Primadophilus Reuteri, Folic Acid, Vitamin E

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