Assumed to have antibodies

[Bunty]

I saw my GI last Wednesday and it has been assumed that I have developed antibodies to infliximab. This assumption has been made as I had a severe reaction at my last infusion, and continuing joint pain for the seven weeks since then. I am to have a blood test done to confirm these suspicions and yet another colonoscopy to determine the state of my bowels.
My GI has suggested that, depending on the results of these tests, I may be put on vedolizumab along with azathioprine. I had to stop aza last year as my liver enzymes went through the roof, however the GI has said there is another drug which can be used alongside aza to help prevent this. I can't remember the name of this drug...can anyone help? And does anyone else take this drug, if so has it worked in stopping the liver problems?
Thank you.
Bunty x

 

[aypues]

ask him about Cellcept instead of Azathioprine (not alongside).

 

[my little penguin]

Ds was on 6-mp at dx and it kept raising his liver enzymes .
His Gi cut the dose of 6-mp and added allopurinol which shunts the 6-mp
I can say we tried and every time we increased the 6-mp to get to therapuetic levels the liver enzymes still went up

Not sure why they wouldn't use Mtx instead
Ds hasn't had any issues with liver enzyme and Mtx at all.

Also why enytvio and not humira ?
Was remicade working until you had a reaction?
Ds reacted to remicade but it was working so he was switched to humira 4.5 years ago and no issues only added Mtx to fix his arthritis


Enytvio won't treat arthritis - neither will Aza
So might be worth asking about Mtx and /or humira if joints are an issue as well

 

[Bunty]

Thanks for your replies.
I've no idea why he suggested one drug over another, I'm not too well up on these drugs to even have asked the question. Remicade/infliximab has given me some improvement but not a lot, it would have been my sixth infusion tomorrow if it had gone ahead.
We are going to talk about my options again once the colonoscopy and antibody results are in, it wasn't a definite that I'll be put on vedolizumab, just a suggestion that he mentioned.
I feel like a need to study for a degree in IBD to get my head round all this.... :/
Bunty x

 

[Clash]

In the six infusions that you've had have they adjusted the disease or shortened the schedule? Also between I fusions have your remicade levels ever been checked?

If antibodies weren'the present I would get trough levels tested and consider adjusting schedule or dose and maybe adding methotrexate before kicking remicade to the curb.

 

[Bunty]

Clash, do you mean adjusted the dose? No they haven't, nor shortened the schedule. I had a trough level test at some stage and it showed a good therapeutic level so there didn't seem any need.
I think they're testing the trough level as well as antibodies when I have blood taken tomorrow.
My last infusion was delayed by five weeks due to me developing what was thought to be psoriasis and needing to see a dermatologist before continuing. It's not psoriasis but is nummular dermatitis so the OK was given to resume infusions. I got the impression my GI thinks the delay could be partly/wholly responsible for me possibly developing antibodies.
Bunty x

 

[Clash]

Ahhh yeah that could definitely be a possibility. My son developed antibodies when he had to suspend his infusions for surgery.

Remicade didn't completely quell his active disease either. Well, actually, remicade plus mtx didn't get the job done.

Hope you get some answers quickly!

 

[aypues]

Ahhh yeah that could definitely be a possibility. My son developed antibodies when he had to suspend his infusions for surgery.

Remicade didn't completely quell his active disease either. Well, actually, remicade plus mtx didn't get the job done.

Hope you get some answers quickly!

was he on 5mg/kg or 10mg/kg?

 

[Clash]

By the time he had to suspend remicade for surgery he was on high dose remicade, 15mg/kg every 6 weeks (he had been at 5 weeks) as well as methotrexate injections equal to 20 mg pill form.

He had an ileocecectomy and when started back with remicade I think he restarted with loading doses but it's been awhile now so I can't be sure.