Inflectra Levels & Antibodies

Hi all,

I recently had my infliximab levels tested and they were below range and I'm on the low (albeit very low) range in antibody level as well. I'm on max dose every 8 weeks. I just stopped Imuran in January after being on it for 3 years. They now want to do max dose every 4 weeks and put me back on Imuran at 100mg. With all that said, I've been in remission and doing fine for 2+ years. They said it's only a matter of time before a flare would start and I could lose ability to use this medicine.

I'm hesitant. It feels aggressive. To double the max dose and put me back on Imuran. She said antibodies this low are reversible if we follow that plan of care. And it's not permanent meaning I could end up spacing out infusions down the road and maybe come off Imuran again as well.

Anyways, just looking for some thoughts or if people have been in similar situations. It's frustrating because I feel fine. But on the flip side, I know if I don't go along with this and a big flare starts, I'm going to be kicking myself.

Thanks,
D

This is a hard one. I have inflectra infusions every 8 weeks and I’m excited to be in remission. Still having chronic fatigue Though, and not sure how the infusions may or may not contribute to this. I hope you find the reassurance you need. I think for me, if I felt healthy and trusted my doctor (both no’s for me atm) I would do it.

Thanks for all these responses. I have had inflix levels tested before, and they were only once in non-therapeutic so we upped the dosage. As for Imuran levels, they have always been below therapeutic level, even at 175mg. My GI said that my low levels are fine and will help to boost Inflectra levels and keep me from developing (even more) antibodies. I spoke with my old GI and she also believes this is a good tactic in being proactive. Better to get me back to a safe place, then slowly decrease medicines, than to do nothing and risk a potential flare. This disease is always about cost/benefit and making informed decisions, which I hope I'm doing.