Antibodies to Remicade- are kids more likely than adults to develop them?
- Thread starter Momtotwo
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I looked for this over a year ago when D had her issue. No papers comparing kids vs. Adults that I could find.
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Best articles I could find, you could compare them to studies done on adults with IBD: http://www.ncbi.nlm.nih.gov/pubmed/15867583
http://www.ncbi.nlm.nih.gov/pubmed/15097438
http://www.ncbi.nlm.nih.gov/pubmed/15097438
DustyKat
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It may well be difficult to find too much on this subject Momtotwo as biologic use in children is relatively new in the scheme of things:
This article is located in the Paediatric IBD - Articles and Research, located as a sticky at the top of the main forum page:
Biologics in Paediatric Crohn’s Disease
It does make comparisons to adults.
Have a scroll through the paediatric research thread, there may be other articles of interest for you there.
Dusty. xxx
This article is located in the Paediatric IBD - Articles and Research, located as a sticky at the top of the main forum page:
Biologics in Paediatric Crohn’s Disease
It does make comparisons to adults.
Have a scroll through the paediatric research thread, there may be other articles of interest for you there.
Dusty. xxx
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The other thing to keep in mind.
Since the drugs are relatively new - they have found you can react to remicade but not have antibodies present . DS did this.
We were told that the test only can look for the current known antibodies - our dermo was convinced there are probably more unknown ones.
There is not a lot of research on kids period because kids represent a very small percentage of the Ibd population . The number of kids under 14 is even less.
Those dx under 5 is almost non existent ( except on here ).
To do research you need a very large population to make valid claims .
Pediatric Ibd just isn't one of those population.
Improve care now is combining data from the large pediatric groups in the US .
At one point they had data on over 10,000 kids.
https://improvecarenow.org/
The Ibd center your at may be involved.
Since the drugs are relatively new - they have found you can react to remicade but not have antibodies present . DS did this.
We were told that the test only can look for the current known antibodies - our dermo was convinced there are probably more unknown ones.
There is not a lot of research on kids period because kids represent a very small percentage of the Ibd population . The number of kids under 14 is even less.
Those dx under 5 is almost non existent ( except on here ).
To do research you need a very large population to make valid claims .
Pediatric Ibd just isn't one of those population.
Improve care now is combining data from the large pediatric groups in the US .
At one point they had data on over 10,000 kids.
https://improvecarenow.org/
The Ibd center your at may be involved.
I haven't heard of any but I was told at the University of Michigan that Remicade is their preferred treatment for kids under 18. My son built-up anti-bodies. UofM had added steroids to his infusions to help prevent the antibodies but, they didn't do much good. After we switched doctors and hospitals my son was put on Methotrexate to help prevent the antibodies. It worked! He went from having a very low level of Remicade left in his system two weeks after an infusion to having an acceptable level two weeks out after just two to three months on the Methotrexate.
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Once you have built antibodies to remicade they don't go away.
Did you son have the promethius test for the presence of antibodies or just the remicade level ?
Methotrexate can increase the efficacy of the biologic and is suppose to lower the risk of antibodies developing ( some studies other studies disagree) but it can not stop the body from producing antibodies once they have started.
Which may be why your seeing higher levels
Of remicade in his blood.
Steriods can only calm down the immune system and reduce the risk of reaction after antibodies have formed since having antibodies increase the risk of anaphylaxis to the drug.
Did you son have the promethius test for the presence of antibodies or just the remicade level ?
Methotrexate can increase the efficacy of the biologic and is suppose to lower the risk of antibodies developing ( some studies other studies disagree) but it can not stop the body from producing antibodies once they have started.
Which may be why your seeing higher levels
Of remicade in his blood.
Steriods can only calm down the immune system and reduce the risk of reaction after antibodies have formed since having antibodies increase the risk of anaphylaxis to the drug.
I'm almost certain it was the Prometheus test (http://www.nestlehealthscience.com/...p-guide-inflammatory-bowel-disease-management). There is only one lab in my area that does it and has the kit, they had to FedEx it to California.
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Promethius lab does multiple tests for Ibd kids including remicade levels and antibody tests.
I would ask the Gi for a copy of the results .
Promethius sends back a report which should be in the medical file.
Its a good idea to keep copies of all lab results , pathology reports and imaging reports .
I would ask the Gi for a copy of the results .
Promethius sends back a report which should be in the medical file.
Its a good idea to keep copies of all lab results , pathology reports and imaging reports .
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I learned recently that the prometheus test is in 2 forms. 1. For antibodies & 2. For drug levels in blood stream. 1. Is to determine if you have built up an immunity to the drug & 2. Is to determine if the dosage is correct for the individual. Just because you/your doc ask for the test doesn't mean the lab tests both 1 & 2. It has to be part of the lab requisition. When we sent the request to Cali the doc had to ask for both. When we started sending it to Montreal the automatically send the results of both. I don't know if it was a location issue or a change of testing practice but now I make sure the doc writes it on the requisition just in case. $295 is a lot of cash especially when you start doing this multiple times.
