Open main menu ☰
HealingWell
Search Close Search
Health Conditions
Allergies Alzheimer's Disease Anxiety & Panic Disorders Arthritis Breast Cancer Chronic Illness Crohn's Disease Depression Diabetes
Fibromyalgia GERD & Acid Reflux Irritable Bowel Syndrome Lupus Lyme Disease Migraine Headache Multiple Sclerosis Prostate Cancer Ulcerative Colitis

View Conditions A to Z »
Support Forums
Anxiety & Panic Disorders Bipolar Disorder Breast Cancer Chronic Pain Crohn's Disease Depression Diabetes Fibromyalgia GERD & Acid Reflux
Hepatitis Irritable Bowel Syndrome Lupus Lyme Disease Multiple Sclerosis Ostomies Prostate Cancer Rheumatoid Arthritis Ulcerative Colitis

View Forums A to Z »
Log In
Join Us
Close main menu ×
  • Home
  • Health Conditions
    • All Conditions
    • Allergies
    • Alzheimer's Disease
    • Anxiety & Panic Disorders
    • Arthritis
    • Breast Cancer
    • Chronic Illness
    • Crohn's Disease
    • Depression
    • Diabetes
    • Fibromyalgia
    • GERD & Acid Reflux
    • Irritable Bowel Syndrome
    • Lupus
    • Lyme Disease
    • Migraine Headache
    • Multiple Sclerosis
    • Prostate Cancer
    • Ulcerative Colitis
  • Support Forums
    • All Forums
    • Anxiety & Panic Disorders
    • Bipolar Disorder
    • Breast Cancer
    • Chronic Pain
    • Crohn's Disease
    • Depression
    • Diabetes
    • Fibromyalgia
    • GERD & Acid Reflux
    • Hepatitis
    • Irritable Bowel Syndrome
    • Lupus
    • Lyme Disease
    • Multiple Sclerosis
    • Ostomies
    • Prostate Cancer
    • Rheumatoid Arthritis
    • Ulcerative Colitis
  • Log In
  • Join Us
Join Us
☰
Forum Home| Forum Rules| Moderators| Active Topics| Help| Log In

Biologics or Pred ?

Support Forums
>
Ulcerative Colitis
✚ New Topic ✚ Reply
12 3
❬ ❬ Previous Thread |Next Thread ❭ ❭
profile picture
Tblock1985
Regular Member
Joined : Jun 2017
Posts : 169
Posted 1/28/2020 5:36 AM (GMT -7)
Hey guys, currently just started another mild flare. Been well for about 4 months now after a severe C-Diff infection, but looks like the UC flare is back again. I had a Colonoscopy procedure 3 weeks ago and although it showed very mild inflammation at the lower end, in general my colon was very healthy, so was pleased with that. Problem is the prep and procedure has probably put me into a flare unfortunatelysad Now, I have been on Pred to much this year, so my Doctors are not to keen on putting me on that again, so we’re looking at other options prior to my colonoscopy which was the biologics route. I have never taken biologics before, but have heard good things about long term remission with it. Would you say Biologics isn’t as Toxic as Pred ? Is it good for getting into remission and maintaining it ? Looking to get on it next week hopefully once they have my stool and bloods back
profile picture
iPoop
Forum Moderator
Joined : Aug 2012
Posts : 16194
Posted 1/28/2020 6:51 AM (GMT -7)
Another option:

1.) For mild inflammation there is always delayed-release coated budesonide-based meds like Uceris or Entocort EC which are only 10% systematic and 90% topical (whereas pred is 100% systematic and that's what causes the awful side effects).

2.) There's also thiopurines like azathiopurine/imuran or 6-mercaptopurine that can treat your UC flareup. You say you are mild, these meds are a bit slow taking 3-months to work so that might not be an issue in your case.

"Would you say Biologics isn’t as Toxic as Pred ? "
Neither is toxic. Yes, biologics are regarded as safer than pred especially when you've been on a lot of pred for a long time cumulatively. As biologics do not do irreversible damage, like long-term pred does. Long term pred usage can cause osteoporosis, glacoma, type ii diabetes as an example. At most Biologics have a chance of an infusion-reaction (from headaches, to trouble breathing, fever temps, etc), but we pre-med to reduce the odds of it, and discontinuing stops them.

"Is it good for getting into remission and maintaining it ? "
There's never a 100% promise with anything UC treatment wise. Odds are about 65% that taking a biologic of your choice will improve your UC symptoms. I've been on remicade since 2012 and in a remission the majority of that time. Some end up switching among biologics after a while, so there's that too.
profile picture
Sara14
Veteran Member
Joined : Mar 2007
Posts : 6235
Posted 1/28/2020 8:16 AM (GMT -7)
Sorry you're flaring. You had mild inflammation during your scope, so I never really thought you were totally in remission. Yes, I think you should do biologics instead of prednisone. They can take months to work though, so that's the only thing....you may need some form of steroid to tide you over in the meantime while waiting to see if they work. I've seen much lower efficacy odds for biologics (I saw 20% for Humira, for example) than iPoop and they haven't really worked for me so far, other than Remicade seemed to work for 9 weeks. If your symptoms aren't too bad and you need some type of fast relief, I would try Uceris/budesonide before prednisone.
profile picture
straydog
Forum Moderator
Joined : Feb 2003
Posts : 18319
Posted 1/28/2020 8:19 AM (GMT -7)
I looked back at your posts in November & you said you were on Aza. Since this is not working it is not unreasonable to add a biologic & the dr was discussing this then.

IPoop explained the pitfalls of prednisone, so there is no point in repeating it, lol.
profile picture
Tblock1985
Regular Member
Joined : Jun 2017
Posts : 169
Posted 1/28/2020 9:05 AM (GMT -7)
Hey guys, yeh I’m on 150MG Aza a day and have been on AZA for years. I’m also currently on highest dose of Mesalazine and nightly Pred enemas. Aza is clearly not keeping me in remission long term like it did before. I’m flaring every 4/5 months which isn’t good enough. Initially I went in remission for nearly 4 years before. I think Biologics is the next step guys.
profile picture
Tblock1985
Regular Member
Joined : Jun 2017
Posts : 169
Posted 1/29/2020 9:12 AM (GMT -7)
Guys, just got feedback from my IBD nurse who’s liaised with my DR. They want to start me on Biologics, so I’m quiet positive now. She has given me the choice of either Humira ( self inject ) or Infliximab ( hospital infusion) , I have chosen the self inject route as I’m pretty comfortable with this with the right instructionS. Should be getting me in clinic ASAP
profile picture
Sara14
Veteran Member
Joined : Mar 2007
Posts : 6235
Posted 1/29/2020 9:16 AM (GMT -7)
I hope it works for you. I've found Humira very easy to use. I use the Humira pens. They have a Humira nurse ambassador program that I found helpful and nice as well. You can sign up for it for free on their website.
profile picture
straydog
Forum Moderator
Joined : Feb 2003
Posts : 18319
Posted 1/29/2020 9:33 AM (GMT -7)
Tblock, glad that you have spoken with the nurse & have made your decision. I had a horrible fear of needles all of my life. I wasn't sure I could self inject, it was easy. Don't forget Humira has a copay assistance card, be sure to check out their site. Good luck on your visit to the clinic.
profile picture
Tblock1985
Regular Member
Joined : Jun 2017
Posts : 169
Posted 1/29/2020 9:43 AM (GMT -7)
Cheers guys. Yeh I’m fine with injections, blood tests etc. They said I was the best patient ever during my colonoscopy haha nothing usually fazes me once I’m set on something. Seeing them in clinic next week, so let’s hope this puts me in long term remission like I achieved all those years ago. It’s certainly I route I feel I have to take.
profile picture
Tblock1985
Regular Member
Joined : Jun 2017
Posts : 169
Posted 2/3/2020 9:39 AM (GMT -7)
Guys, started another course of Steroids. Didn’t particularly want to, but it’s going to take a good 3 weeks or so for the application to go through and get accepted for the biologics and I’m not getting any better, so my IBD nurse instructed me to go on the Pred 40MG. Hopefully this will settle things ( usually does ) and then I can start the Biologic treatment, which is hopefully going to be my saviour in regards to less steroid usage after this. But I can’t be waiting 3/4 weeks in this flare, as the Enemas are doing nothing as the inflammation has gone to high. I go away to Spain end of month for my Dads 60th with the family and have my wedding In Italy in May, so no way am I risking flaring for that. I’m tackling it head on and hopefully the biologics will see me through after.
profile picture
Sara14
Veteran Member
Joined : Mar 2007
Posts : 6235
Posted 2/3/2020 10:02 AM (GMT -7)
Yeah, and after you start Humira, it can take 8 weeks to work...it is most likely not going to work very quickly, so you may have to be on steroids a while. Good luck!
profile picture
Tblock1985
Regular Member
Joined : Jun 2017
Posts : 169
Posted 2/3/2020 10:03 AM (GMT -7)
Exactly Sara, cheers
profile picture
Tblock1985
Regular Member
Joined : Jun 2017
Posts : 169
Posted 2/27/2020 2:14 AM (GMT -7)
Guys, just thought I’d update you on situation. Biologics approval was needed and just been approved for me, so I go for my 1st infusion next week. Then another infusion 2 weeks after, then 1 more 3 weeks after that, so 3 infusions in total. I’m currently still flaring, but I’m just over 3 weeks into a 40MG Pred course which I had to go on unfortunately whilst waiting for the biologics approval. I’m on 35MG, reducing to 30MG next week when I get my infusion. Flare is better, roughly 4 times a day now with a mixture of liquid/ Solid stools. Blood very minimum now if not anything, the odd spec. Pred taking its time, but does seem to have made a difference. Just hoping the biologics is the kick I need to not only kill this flare, but keep me in remission long term. Never have issues getting rid of flares, but I have been flaring to much in a yearly period and relying on Pred to much to combat it, hence why we are now going down the Biologics route. I’m pretty optimistic as I usually respond well to medication so hoping this is the right drug for my flares.
profile picture
poopydoop
Veteran Member
Joined : Dec 2018
Posts : 922
Posted 2/27/2020 2:39 AM (GMT -7)
Hey, if you're having infusions does that mean you're doing remicade/infliximab? I always regret not having started biologics sooner (not that I had a choice....hospital protocol...) because they were so much more effective than azathioprine
profile picture
Tblock1985
Regular Member
Joined : Jun 2017
Posts : 169
Posted 2/27/2020 3:02 AM (GMT -7)
I think infliximab, but will double check. My Doctor said he wants to combat it with the strongest Biologics as wants to push me for long term remission. Yes, I have been relying on Pred to much. Time for another solution as my flares are coming back to frequently.
profile picture
iPoop
Forum Moderator
Joined : Aug 2012
Posts : 16194
Posted 2/27/2020 6:20 AM (GMT -7)
Glad you finally got the approval. Insurance and approval is such a painfully and frustratingly slow process.

I would not reduce the pred until you know the biologic is working. Reducing pred from 40 to 35 before staring infliximab does not sound like a good idea to me. At least wait until you've gotten week 0 and week 2 loading doses before tapering pred any.

I hope infliximab/remicade works as well for you as it did for me. It was a total game changer and still on it (and in a remission) 7+ years later.
profile picture
Tblock1985
Regular Member
Joined : Jun 2017
Posts : 169
Posted 2/27/2020 6:49 AM (GMT -7)
Fantastic news @ipoop. I have been hearing some good things about it. I initially had a 5 year remission period after my very 1st terrible flare and ended up flaring again the moment i decided to come off the Azathioprine. Silly decision, but you live and learn.
profile picture
Rosiedays
Regular Member
Joined : Jul 2017
Posts : 313
Posted 2/28/2020 7:48 AM (GMT -7)
T Block, I hope this helps you. I was glad to hear that you have been feeling better since that awful c-dif situation and hope you get back on your feet much more quickly this time!

I may also go on a remicade biosimilar next month. My situation is a bit different. I’ve had no symptoms since Christmas, except a little discomfort now and then, but my GI says my colonoscopy results show patches of active flare, most serious near the small intestine. Her opinion is that I have crohns, not UC like originally diagnosed, and that it will get worse. I’m probably going to go ahead with infusions because I’m scared of scar tissue leading to fistulas or blockages
profile picture
CCinPA
Veteran Member
Joined : Dec 2014
Posts : 1572
Posted 2/28/2020 7:57 AM (GMT -7)
You can get co-pay assistance for remicade/infleximab so you will only have to pay $5 for the med. Be sure to sign up for it.

https://www.janssencarepath.com/patient/remicade/cost-support
profile picture
iPoop
Forum Moderator
Joined : Aug 2012
Posts : 16194
Posted 2/28/2020 9:47 AM (GMT -7)
Pfzier also has an equivalent copay assistance program for Inflectra, if you get put on it.
profile picture
Tblock1985
Regular Member
Joined : Jun 2017
Posts : 169
Posted 3/6/2020 5:24 AM (GMT -7)
Finally back into remission symptoms again guys. Full formed stools now. No symptoms. The Pred has kicked it into touch which it always does with me. I’m on 20MG now. Once I hit remission with the Pred, I never usually flare up again when tapering. Issue has been I have been flaring far to often, so every 4/5 months I’m well, turn back to flaring again. Biologics got delayed a week, so I should be on my 1st infusion at some point next week. Good news is the Pred has worked it’s magic. I just hope the biologics is the catalyst for me to stay in remission long term, that’s the plan.
profile picture
iPoop
Forum Moderator
Joined : Aug 2012
Posts : 16194
Posted 3/6/2020 8:41 AM (GMT -7)
Glad you've gotten some relief. Pred is incredible in making us feel normal again fast (if it only wasn't for the side effects..).
profile picture
Tblock1985
Regular Member
Joined : Jun 2017
Posts : 169
Posted 3/6/2020 10:12 AM (GMT -7)
You know what, I do really well on Pred in terms of side effects. Only thing I get is spots on my chest. I don’t get moon face, aches or anything, obviously long term use will increase long term damage, hence why I’m going down the biologic route now as I’m relying on Pred to much.
profile picture
iPoop
Forum Moderator
Joined : Aug 2012
Posts : 16194
Posted 3/6/2020 10:46 AM (GMT -7)
You're lucky I know a few who have few side effects on pred. I get them ALL, every single one, multiple at once. It's rather craptastic lol. At 40-mgs, I had bad insomnia, night-sweats, rapid heart beat, and insatiable appetite.
profile picture
Tblock1985
Regular Member
Joined : Jun 2017
Posts : 169
Posted 3/8/2020 4:10 AM (GMT -7)
Wow, I get the odd night sweats when I’m on a high dose, 40MG above usually. When I been on 60MG I got a few bits and pieces, but generally my starting dose for kicking a flare is 40MG and 9 times out of 10 it puts me in remission all the time with barely any side effects apart from the spots like I said. Oh and of course the eating habits hahaha but I’m relieved as I get back to the gym and start putting on healthy weight again smile anyway, I’ll keep everyone updated on my biologics progress over next few weeks on here if anyone is interested
✚ New Topic ✚ Reply
123

More On Ulcerative Colitis

Traveling With Inflammatory Bowel Disease

Traveling With Inflammatory Bowel Disease

CBD And Pain Management: Is This Supplement Right For You?

CBD And Pain Management: Is This Supplement Right For You?



HealingWell

About Us  |   Advertise  |   Subscribe  |   Privacy & Disclaimer
Connect With Us
FacebookFacebook TwitterTwitter InstagramInstagram PinterestPinterest LinkedInLinkedIn
© 1997-2021 HealingWell.com LLC All Rights Reserved. Our website is for informational purposes only. HealingWell.com LLC does not provide medical advice, diagnosis, or treatment.