a.) You had said the cancer odds are low with biologics but I am not sure you know how really low they actually are.The odds of lymphoma for the average Joe on the street (no meds, no uc) is 2 in 10,000 (or 0.002%), the odds of lymphoma for somebody on biologic meds remicade/humira is 6 in 10,000 (or 0.006%). Very low odds. I would argue that your odds of cancer from uncontrolled/untreated uc is much higher than with the biologics. As inflammation from uc can turn into dysplasia which then becomes cancer over time.
b.) Humira might be worth a shot as some of the people here have had success with it. New meds are coming out all of the time, so that does pose some hope that if humira stops working that there will be something else to try. Right now there is also SIMPONI (golimumab) on the market which a couple people are trying out here. In the near future there is Vedolizumab (trade name Entyvio) that is currently going through FDA approval process and it uses a very different process than the other biologics (it isn't a TNF-alpha blocker like all of the rest but something entirely different). Who knows Humira may work for him indefinitely and keep him in a solid remission for years, don't know unless you try. The future is very hard to read or predict, what matters now is what improves your son's quality of life today.
Sounds like your son developed antibodies to remicade making it ineffective for him. He should also be on an immunosuppressant (e.g., 6mp, imuran, aza) at the same time as the biologic, as that decreases the odds of him developing antibodies and I would recommend that in the future.
35 yr old male/ proctosigmoiditis
Rx: Remicade 5mg per kg, every 8 weeks
Daily 75mg 6MP + 5g Lialda + Rowasa + 7mg Prednisone (tapering at a snail's pace)
Diet: Diet mods and supplements haven't done a thing for me.
Don't let knocks on the bathroom door bother you because normal people can hold it for a very long time.
Post Edited (iPoop) : 1/3/2014 7:07:07 AM (GMT-7)