Posted 8/20/2022 9:40 AM (GMT -8)
I posted before. I’m a chronic Crohn’s patient, who was diagnosed in 2007 but only started Remicade in 2016 after I developed a perianal fistula. The fistula was claimed to have healed in 2019 and ever since I have been taking Remicade every 8 weeks. When I had my fistula, I used to take it every 4 weeks. Since November 2021, I started complaining from constant soiling and severe rectal pain. I was put on Pentasa enema 4g and Trud enema but to no avail. In 2017, my GI informed me that my rectum was not responding to Remicade and that’s why, I have to take cortiment (budesonide MMX 9 mg). Things kept being fine until I had to taper budesonide. I’m on a 1.25 mg dose ( one 9 mg tablet every week). I took Pentasa enema for months but for the last 4 weeks, when I need to have a bm after taking it, I have severe abdominal pain while on the toilet, diarrhea and vomiting. It’s really weird and it can happen anywhere whether at home or once it happened when I was at a mall.
Saw my GI on Wednesday and we discussed the idea of changing Remicade. My trough levels are high and I have no antibodies, however, I don’t think it’s working anymore. My GI said and I seconded him that we don’t want to change Remicade now. But on a second thought, I feel I was mistaken, I want to change Remicade. I’m very sick nowadays even my intestines hurt. My GI prescribed 3 steroid injections every other day. Took 2 injections but I don’t feel any better and I returned to the 1.25 mg budesonide dose as I was taking Entocort 1mg. My question: Is switching to Stelara worth giving up the so called “effectiveness” of Remicade as there are no antibodies and the trough level is high (within therapeutic level) and it would ease my rectal pain or is it a risk?