When patients with IBD begin to lose good response to Remicade - article

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Ides
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Date Joined Nov 2003
Total Posts : 7097
   Posted 6/4/2010 7:43 PM (GMT -6)   
Journal Watch Gastroenterology published an article today that discusses what should be done for patients that find that Remicade is losing its effectiveness. The article can be found here:
 
Not sure if one has to register or not to read the article. If those of you that are interested cannot read the article I will come back and summarize it for you the best I can.
Moderator Crohn's Disease, IBS, and Osteoarthritis Forums
CD, Ankylosing Spondylitis, lupus, small fiber peripheral neuropathy, avascular necrosis, peripheral artery disease, pulmonary hypertension, degenerative disc disease, asthma, severe allergy and a host of other medical problems.
 


Rider Fan
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Date Joined May 2008
Total Posts : 1445
   Posted 6/4/2010 7:52 PM (GMT -6)   
That's really interesting, thanks.

I wonder if a GI could check for Humira HACA's? Also, I wouldn't mind having the Humira levels in me checked but I doubt my GI would do it.

Given that 6 of the 7 people who had a Remicade holiday had HACA's (which I presume make the Remicade useless?), that is further evidence that people on biologics should stay on a regular schedule.
33 y/o male. Dx'ed in 1999. No surgeries.

Current meds: Humira 2/27/09. Proferrin iron pills.

Reduced gluten and dairy.


Go Saskatchewan Roughriders!


Ides
Forum Moderator


Date Joined Nov 2003
Total Posts : 7097
   Posted 6/4/2010 8:36 PM (GMT -6)   
I'm not sure if this article will help answer your question, but it might.: http://www.medscape.com/viewarticle/490671
 
I believe that the HACA test is for antibodies to Remicade only.
Moderator Crohn's Disease, IBS, and Osteoarthritis Forums
CD, Ankylosing Spondylitis, lupus, small fiber peripheral neuropathy, avascular necrosis, peripheral artery disease, pulmonary hypertension, degenerative disc disease, asthma, severe allergy and a host of other medical problems.
 


PV
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Date Joined May 2006
Total Posts : 1177
   Posted 6/4/2010 9:38 PM (GMT -6)   
Oh, good article. Thanks for posting it!

So, it sounds like, if remicade is detected in sub-therapeutic levels, you should increase the dosage and/or frequency of remicade. If HACA is detected, patient should be switched to a different anti-tnf agent. If the patient is showing active disease, but has adequate (therapeutic) levels of remicade, then, the patient should be switched to a completely different medication that is not an anti-tnf agent.

That's good to know. I live in dread of remicade not working for my hubby. This at least tells me what maybe the best course of action should that dreaded event occur.

Thanks so much.

PV
Husband with Crohn's
Diagnosed March 2003 Ulcerative Proctitis
Diagnosed March 2008 Crohn's & C-diff, hospitalized 45 days
Crohn's in Remission since June 2008
C-diff recurrence Sep 2009
Reactive Arthritis Nov 2009
Currently c-diff free
Osteopenia of spine (Mar 2010)
Canasa (1gm), Lialda (4.8 gms), Remicade (8 weeks)
Currently In Remission

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