They do say that Entyvio can take longer to work than Remicade, that it's a slower-working drug.
If you fail anti-TNFs, rest assured, there is no problem starting Entyvio. In fact not only can it work, but I believe in the leaflet for Entyvio it even says that it is a treatment for people who have tried other biologics like anti-TNFs that haven't worked. So don't worry about
The only issue I would have in your case is, if you start Remicade and it works, it might be quite dodgy to stop it. What if the Entyvio doesn't work and you have come off a drug (Remicade) that does? That's a hypothetical scenario but I think that is something to bear in mind. As for the immunosupression effects you are wise to be concerned and some people would point-blank refuse these kinds of biologics I'm sure, but to be honest isn't doing whatever you can to get in remission more of a priority right now? Nobody can make decisions for you but that's a few of my thoughts. Also, whilst it's probably advisable to be on a second immunosupressive drug at the same time for multiple reasons, it's possible to go on Remicade without doing that...just saying. But if you are on a second immunosupressive drug then I think they find Remicade tends to work better, the immunosupressive drug will help your disease anyway AND it can stop antibodies to the Remicade forming.
EDIT: I believe most people would say there would also have to be somewhat of a gap between Remicade and Entyvio. Probably wouldn't have to wait the 6 months or whatever it is for it to come out of your system completely, but you wouldn't want to have them immediately one after the other. And one final point which is about
antibodies - you can develop antibodies to Remicade after a while. I think the extra immunosupressants would make that more unlikely. The antibodies can stop the drug working if they do form. I've read people who have said "don't come off Remicade because if you try to go back on it you could have developed antibodies and it might not work any more". I believe that when I looked into it a bit more closely, while that's possible, there's no more chance of them forming if you come off it and restart, than there is if you kept on it. Can anybody check that? In fact, I'm happy to anybody to read this entire post and show me I'm wrong about
all of it, but that's the knowledge that I picked up from what I read when I was on Remicade and looking at Entyvio.
"It shown to be safer and more effective in anti-TNF naive patients" - that's new knowledge for me, and interesting! Thanks.
And to share my own experience, Remicade didn't work and now on Entyvio. Been on it quite a few months and I do seem to be better than I was, but not perfect, and it's so hard to tell as I have started other medication also and symptoms go up and down! Wasn't sure if it was doing anything, had a dose increase recently to every four weeks. One thing I can tell you for sure: I'm not in remission. But I'm also very far away from my worst symptoms. Maybe I'm crawling my way to remission. Hopefully! Fingers crossed.
Post Edited (~ chicken wings ~) : 5/25/2018 10:32:56 AM (GMT-6)