What's the next step after Humira begins to fail?

Hello, friends!

I've been on Humira for a year to treat my UC. It has really helped calm my symptoms, and I've had a relatively healthy year.

However my symptoms are slowly returning. My doc prescribed a hydrocortisone enema, which I have just started.

I'm just curious what other folks have been prescribed once a biweekly shot of Humira fails.

Thanks everyone!

Sister meds are remicade or Simponi.
Other biologics are stelara, entyvio. There's similar xeljanz.

If you're failing Humira, the first thing to do is to try to figure out why. That requires measuring trough levels and checking for antibodies.

Then you go from there. The next med you would try would depend in part on those results.

beave said...
If you're failing Humira, the first thing to do is to try to figure out why. That requires measuring trough levels and checking for antibodies.

Then you go from there. The next med you would try would depend in part on those results.

Just got blood work done. My Humira levels were good and I have no antibodies. So it looks like this current resurgence in symptoms has been caused by recent stress or that my body is not responding well to the Humira.

magicbeans said...

Just got blood work done. My Humira levels were good and I have no antibodies. So it looks like this current resurgence in symptoms has been caused by recent stress or that my body is not responding well to the Humira.

Hi Magicbeans, this is what happened to me starting in around Spring 2020. I had good therapeutic levels and no antibodies against Humira but it wasn't working, so I was switched to weekly injections, but I flared again around Dec 2020, and was told it was time to switch drugs in 2021. After a long time waiting for the paperwork to be sorted I started on Xeljanz in 2021, but it didn't work for me (and all my joint pains came back) so I switched to Stelara a few months later. So far I've had the IV dose, and one injection (with one coming up next week) and I'm in remission with normal faecal calprotectin results, and no joint pain.

Unfortunately it's a case of trial and error when you switch to new drugs, but if one doesn't seem to be working it's worth trying a different mechanism. Xeljanz is a JAK inhibitor which works really well for some and not others. When Xeljanz failed I switched to Stelara, a monoclonal antibody (MAB), but anti-interleukin rather than anti-TNF.

Good luck, and I hope you find the drug that works for you.

"I tried both for a year when I only had UP. The food anxiety did a real number on my mental health.

I did learn a lot though from the diets. My current diet is vegetarian, very simple and has no added sugar. I mostly eat oats, lentils, rice, apples, banana, vegetables, and fermented vegetables. I fast from 1pm until sunrise every day. This diet works well for me."


when you say it works well for you, do you mean from a mental health standpoint ?

TT