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What are my options? Bridge to biologic

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Ulcerative Colitis
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Posted 1/19/2021 10:24 AM (GMT -7)
Hey all,

I am in the worst flare i've ever had since I had to go off mesalamine/balsalazide meds due to neuropathy I developed. I tried Budesinode and it didn't help or made things worse. I went back to mesalamine this week out of desperation, but can't tolerate the side effects anymore. I am only having about 2 BM per day. However, I have several other times where just mucous and blood comes out of me each day. Not usually a large amount, but today there was more blood and I got really worried/scared.

i spoke to my GI about Entyvio since I can't tolerate mesalamine. However, since it's slow acting, what can I take as a bridge to get out of this flair and start entyvio?

I appreciate any help!
Posted 1/19/2021 10:30 AM (GMT -7)
Prednisone? Have you tried the uceris foam? It’s more topical than the pills. I always found it pretty soothing. Otherwise there’s steroi enemas. Have you tried mesalamine suppositories or enemas? Maybe the topical effects wouldn’t cause the same effects as you’re seeing with oral meds?

Sorry you’re going thru this. but I hope entyvio works for you. I started seeing slight improvements early on as I was able to successfully wean off prednisone for the first time. I’d say by 3 months I was seeing only occasional symptoms. Rectals were what I used on those days.
Posted 1/19/2021 10:42 AM (GMT -7)
Thanks. I am doing the mesalamine 4G enemas and haven't tried uceris foam yet. Can you use both the uceris foam and mesalamine 4G enema or switch? Which is more effective.
Posted 1/19/2021 10:44 AM (GMT -7)
I've heard of xeljanz being used as a bridge to biologics (since many people respond within 3-7 days and it's safer than pred) but it's not a mainstream protocol
Posted 1/19/2021 12:01 PM (GMT -7)
I’ve never actually used the enemas. Uceris foam can be used twice a day. I used it during the day and Canada suppositories at night.
Posted 1/19/2021 12:02 PM (GMT -7)
I also can't do anti-tnf ideally since I have neuropathy. Those meds are listed under meds that can cause peripheral neuropathy. That's why Entyvio was an option.
Posted 1/19/2021 2:10 PM (GMT -7)
Xeljanz is a JAK inhibitor, and no cases of peripheral neuropathy using it.
Hope you find some relief.
Posted 1/19/2021 7:04 PM (GMT -7)
Thanks. I think i'm already set on entyvio because it seems like a lighter medication and is only gut specific immunosuppression. Just need a bridge before I start Entyvio and it begins to work
Posted 1/20/2021 4:33 AM (GMT -7)
I would try Budesonide foam or enemas as a bridge. In the beginning, you can experience some adverse effect like burning but is usually transient.
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