Antibodies and using Anti-TNF, biologicals

[Bizkid]

Hey Guys a quick question,

For my colitis I was on Remi for a year and it stopped working, then on Humira 11 months and now that has stopped working. Is there something that can be taken or done to slow or decrease the chances of anti-bodies building up? It would be great if these drugs would last at least 3-4-5 years. Imuran is out f the question that worked great for 8 years and then stopped, hence the Remi and Humira.

thx

 

[nogutsnoglory]

I never heard of anything like that and would be interested if it existed. I think not because wouldn't everyone here be on it? Are you going to try Cimzia next? My GI did say some do better with Cimzia and he isn't sure why.

 

[Clash]

The immunosuppressants are used in combination with biologics to decrease the chances of antibodies.

Methotrexate at doses as low as 7.5mg per week is shown to reduce antibody formation and hasn't shown a significant increase in cancer or infection rates.

here is some more info from that source

If a patient is on the combination therapy and gets an infection, they drop the immunosuppressant.

- If the patient is in remission at 12 months they'll consider stopping the immunosuppressant but monitor the patient very closely.

- If response is lost, either increasing the dose or shortening the dosing interval recaptures response in the majority of patients.

- If the dose is increased, after 6-12 months the authors try to reduce the dose back down to the original dose. If the response is lost again, they'll go back up and maintain at the higher dose indefinitely.

- With Humira, if response is lost, they increase the dose from 40mg every two weeks to 40mg every week. After six months if the patient recaptures response, they try to take the dose back to once every two weeks.

source

 

[Bizkid]

Yes that is the info I was looking for. Im not sure my Dr is familiar with Metho. but I will ask him. Like I said I respond well to the Anti-TNFs...............for a year. With Colitis I have I believe 1-2 more options left
Simponi
Stelara
Vedomuzilab
I say 1-2 because I may not be approved for all three and I surely dont want them to last just 1 year and start all over again.................Im changing drugs faster then they are coming out. Having said that I think that this is a common challenge with anti-TNFs.......the are sooooooooooo expensive and last a very short period. Is it even worth the cost to the heath care system for such a short period? However if it could last 3-5-10 years it makes a big difference imo, maybe never requiring surgery.

 

[Clash]

You may also want to look at this info:

Of those who initially respond to anti-tnf medications, 40-50% will stop responding within 12 months

- Thereafter, data shows that 10-15% will lose response on a year by year basis.

- When you experience a secondary loss of response, you can increase the dose, shorten the interval between doses, switch to another anti-tnf, or switch to another type of medication.

- Just as with primary nonresponders, it is important that your doctor make sure that you're not experiencing symptoms that are not actually indicative of loss of response.

- At the time of the article, only antibodies to Remicade could be tested for. I'm curious of they have tests for Humira and Cimzia yet.

- If someone appears to be losing response, making sure that inflammation is back via CRP, ESR, increased platelets, fecal calprotectin is important so as to rule out other causes such as infection.

- The author suggests someone who appears to stop responding should be evaluated via colonoscopy, capsule endoscopy, CTE, or MRE as well.

- A study out of the Mayo Clinic found that about 50% of people with symptoms of a flare were not actually inflamed and it was coming from some other cause.

It would probably be a good idea to read the entire article I quoted from and that can be found here:

source

 

[Mountaingem]

I take Methotrexate to prevent the buildup of antibodies, and so far so good. The medication, though, is losing its efficacy.

 

[Astra]

My doc has just added Metho to my meds too, in addition to Humira, cos it doesn't seem to be working after 7 months, early days yet tho.

 

[Bizkid]

Well just based on observation, Remi and Humira seems to work 1-2 years for people. It sure works but for how long? It started with Remi I believe and then a plethora of ANTI-TNFs came out. So we can have a hundred drugs out there but they all have the same issue.