By far, the most dangerous medication for UC is prednisone over long term use as it is guaranteed to give you one or more of the following: Osteoporosis, type ii diabetes, glaucoma or other nasties. Not a matter of if, but rather a matter of when. After a full year, you are in the long term steroid use club, and you need to find and expedited way to get off of pred safely. Have you had a recent colonoscopy, flexible-sigmoidoscopy, CRP, or fecal calprotectin stool test done to assess your current inflammation levels?
It sounds like you have a severe case of UC and I would agree with your doctor that biologics are best.
Entyvio runs the risk of PML
Entyvio has had zero incidence of PML, it was developed specifically to avoid the PML complications of earlier drugs within it's class. Entyvio is a gut-specific immunosuppressant (rather than body-wide) and a good option.
Remicade runs a huge cancer risk if you get it, you are much less able to fight it and anytime you get an infection or even a cold, you need antibiotics. Also, you can develop antibodies to it pretty quickly so if one day down the road you really need it, it might not be an option even. And who knows if it actually causes certain lymphomas and it does tax your liver pretty hard.
You really need to look at the actual risks versus benefits of using biologics. You will find that the odds of the side effects are actually quite low once you take a deeper dive into it. Everyone is worried at first as words like cancer are darn scary, and it's only human nature to assume that the worst case scenario will happen to us. I found it comforting to look at the odds and it helped me in my decision. about
65% of people see an improvement within their UC symptoms from remicade. The risks are less than 1 percent.
The odds of getting cancer while on Remicade are 4 in 10,000 (or 0.04 percent). The odds of the average, healthy person on the street getting cancer are 2 in 10,000 (or 0.02 percent). Of those who get cancer from remicade, 66 percent are able to put it into remission. So, we're not at all talking about
a HUGE cancer risk, but rather a statistically small odds, and very unlikely your or I will get it. And having uncontrolled UC inflammation for a year actually has higher cancer risks than any biologic does.
It's never a good idea to get antibiotics for a cold, as it will not do anything.
Antibody formation isn't all that common. I've been on remicade for over 3 years now and have no trace of antibodies within my body. The best practice is to start remicade concurrently with an immunomodulator (Imuran/azathioprine or 6MP), which I did, to reduce the odds of antibodies. Most do not get antibodes, only a few do. Antibodies in low concentrations can be handled by increasing the remicade dose, bringing the patient back into response. In cases of strong antibody formation, then another med, like Humira is tried and there's no guarantee that antibodies will form for that new med (often they do not). A few get antibodies immediately despite following best practices, some never get antibodies even without immunomodular use, and it all varies.
The Crohn's and Colitis Foundation of America is the source for these statistics, and has some great risk versus benefits discussions. I'd strongly suggest you read and/or watch the presentations, as it appears you have some misconceptions about
it, and perhaps some undue fear as a result:
Remicade is the only UC medication to ever put my UC into remission, and I've yet to experience a side effect.
Moderator Ulcerative Colitis
John, 38, UC Proctosigmoiditis
Rx: Remicade @5mgs/kg/6wks; 50mgs 6MP, 4.8g Mesalamine DRUC urgency, there's just no prize for second place. Aim for the gold or brace for a poopslposion.
Post Edited (iPoop) : 2/21/2017 7:00:55 AM (GMT-7)