After a 2-3 years of endoscopic remission (I was first diagnosed in 2013), it appears inflammation is back, as I did a fecal calprotectin and scored 340. I'm not really showing any clinical symptoms as I never really do - it's only endoscopically that my UC really shows. Other blood work still looks good - good CRP, etc. Will be scoped in a few days and go from there. Have been on Azathioprine for several years (first 50mg, then 100mg, which is what put me into remission). Also Mesalamine 1.2g per day. Sounds like those meds are no longer working well though. We'll see. I suppose upping Azathioprine to 150mg is possible, but I suspect a biological is the next step.
But, I also suspect I'm on the brink of getting a rheumatoid arthritis diagnosis. My joints have been hurting for a few weeks. I was previously diagnosed with "Mixed Connective Tissue Disease" by a rheumatologist when I was working overseas, but with no real symptoms to speak of. Now, however, the arthritis component is noticeable and I suspect a rheumatologist is probably going to say I have actual RA. We'll see on that too.
So, I'm suspecting my gastroenterologist may say it's time to try a biologic for my UC if the pancolotis shows to be back upon endoscopy. I'll then consult with a rheumatologist about the arthritis.
My question is, do any of the biologics seem to be at the front of the pack in terms of treating BOTH UC and RA? Anything I need to be studying up on, or is it pretty much doctor's pet med gets tried first?
Humira
MODERATOR-UC FORUM
female - diagnosed with moderately severe proctitis/colitis/mild diverticulitis
6mp - 50 miligrams
Lialda
Repatha - 140 miligrams
Prolia - 60 mg
Calcium with Vitamin D
Zinc
folic acid
"Fly under the radar" - Dad -
MODERATOR-UC FORUM
female - diagnosed with moderately severe proctitis/colitis/mild diverticulitis
6mp - 50 miligrams
Lialda
Repatha - 140 miligrams
Prolia - 60 mg
Calcium with Vitamin D
Zinc
folic acid
"Fly under the radar" - Dad -
If you do have RA you will want a med that works for both. I believe there are several meds that would work. Humira, Remicade for sure, maybe Skyrizi or some others.
67 yo female diagnosed UC 2013. Remission on Entyvio 10/2016-12/2017. Humira didn't do much Nov 2018. Remicade (5 mg 3/2019, 10 mg 8/2019, 6 wks 1/2020, 4 wks 4/2021), REMISSION 12/2021!! Current: Inflectra 10 mg/4 wks 1/2023, Dexilant, cocktail of meds for hypertension
67 yo female diagnosed UC 2013. Remission on Entyvio 10/2016-12/2017. Humira didn't do much Nov 2018. Remicade (5 mg 3/2019, 10 mg 8/2019, 6 wks 1/2020, 4 wks 4/2021), REMISSION 12/2021!! Current: Inflectra 10 mg/4 wks 1/2023, Dexilant, cocktail of meds for hypertension
I'll be starting on a biologic very soon as well. My calprotectin was over 800 last week, though I am back on daily Qing Dai (to assist with inflammation) and some mesalamine suppositories to help until the treatment begins, so I think I've already come down a bit. They gave me a choice of 3 biologics, and I have no idea which is ultimately "better," nor do I think it really matters, but Skyrizi is where I landed because the self-injections were only every 8 weeks (after 3 loading infusions), versus the other two options with injections every 4. So we'll see how it goes. But I'm ready to stop thinking about my poop every day. From here we need to see what insurance says and I'll likely have to apply for financial assistance.
What did you end up deciding?
48, Left-sided UC since 2002
Current meds: Colazal & mesalamine suppositories (& Synthroid, Losartan, Xyzal)
Supplements: VSL#3, Curcumin, Red Yeast Rice w/CoQ10, Vit D, Zinc Picolinate, Liver Support, Qing Dai occasionally
Colonoscopies: 8/9
Status: in a very minor flare, almost over
Past meds: mesalamine, Rowasa enemas, Asacol, Imuran (12y), antibiotics (1x), prednisone (1x), budesonide (2x)
What did you end up deciding?
48, Left-sided UC since 2002
Current meds: Colazal & mesalamine suppositories (& Synthroid, Losartan, Xyzal)
Supplements: VSL#3, Curcumin, Red Yeast Rice w/CoQ10, Vit D, Zinc Picolinate, Liver Support, Qing Dai occasionally
Colonoscopies: 8/9
Status: in a very minor flare, almost over
Past meds: mesalamine, Rowasa enemas, Asacol, Imuran (12y), antibiotics (1x), prednisone (1x), budesonide (2x)
Glad to hear you're moving forward with a biological and hope it offers a positive impact on your quality of life!
I just had my colonoscopy today. It actually looked pretty good. The doctor noted some "decreased mucosal vascular pattern in the sigmoid colon" but other than that, the rest of my colon looked good. As I understand it, this is a pretty low grade of inflammation, and given that it's limited to the sigmoid colon, I'm hoping they'll let me try some mesalamine enemas to get on top of that before considering a biologic or change of my azathioprine. But I'm open to hearing whatever the doc and PA think is called for. I was happy he didn't find a bunch of inflammation - I've had pancolitis in the past, so seeing images of a nice, clean looking colon is a good feeling!
I just had my colonoscopy today. It actually looked pretty good. The doctor noted some "decreased mucosal vascular pattern in the sigmoid colon" but other than that, the rest of my colon looked good. As I understand it, this is a pretty low grade of inflammation, and given that it's limited to the sigmoid colon, I'm hoping they'll let me try some mesalamine enemas to get on top of that before considering a biologic or change of my azathioprine. But I'm open to hearing whatever the doc and PA think is called for. I was happy he didn't find a bunch of inflammation - I've had pancolitis in the past, so seeing images of a nice, clean looking colon is a good feeling!