It's a tough choice. I agree on your throught it's a tossup between entvyio or Entrolizumab.
Not sure on retrying remicade, I'd have to know more about
your uc experience about
it. I'm guessing you didn't do well on it, or else you wouldn't be asking. How long have you been on remicade? Did you have any response to remicade all? Did you stop it, and if so how long (off for more than a month then forget it)? My gut-feeling is if you didn't do well, then try something else. Remicade is an anti-tnf blocking medication (as are simponi, humira) that interferes/blocks your immune systems ability to signal an attack "send inflammation over here". The reality is 60 percent have a response, and only 30-ish percent of those people reach remission. Tnf-alpha is one way your immune system can signal an attack, but their are other mechanisms, as well, and it can work around tnf-alpha (for some).
Entvyio is an entirely different class of biologics (site specific immunomodulators working on madcam1), so that gives you a chance that you might respond better to it. It's anti-adhesion medication that blocks an attack on gut tissue, by trapping lymphocytes within the circulatory system (if lymphocytes can't adhere to capilary walls via madcam1 and transfer themselves into gut tissue, then they cannot attack which causes inflammation). Downside is entvyio takes 12-14 months to work, slow acting. Some have tried it here, and only a few had really great results (given they'd already tried and failed the rest of the meds, as well). Maybe enough haven't tried it? Don't know.
I don't know much about
Entrolizumab, myself. I know it's a site-specific immunomodulator that works in-part as a madcam1 blocker (anti-adhesion) which is what Entvyio does. It's plausible that this is an improved version/more advanced version (there's a great video on it's website describing how it works). I'd look at the clinical trials closely, and ask your doctor what kind of response are people seeing, can he contrast/compare them? Would you get the medication or placebo? If you are getting the real deal then it might be tempting. Downside is it's not fully vetted yet.
Moderator Ulcerative Colitis
John, 37, UC in remission
Rx: Remicade @5mgs/kg/8wks + 6MP @50mgsUC urgency is crapping in a trashcan because you cannot wait for your spouse to finish wiping; true story
Post Edited (iPoop) : 11/11/2015 5:36:56 AM (GMT-7)