Biologic's question

[AliGilbreath]

I was diagnosed with Crohn's Disease November 15. Doctors are now talking about biologics and I am just curious if anyone knows what doctors normally start CD patients off with first.

 

[JaimeM]

I did, it is being seen more that if you are aggressive with biologic treatment right away it can stop the disease from progressing to severe crohns.. I was on Remicade for 6 years and did fantastic on it. I went off remicade for some reason to have a kid(i wouldn't do that again looking back) but have had problems since then. However remicade was my miracle drug.

 

[Justanothercp]

I've had Crohns for about 25 years, my MD started me on meds that had the least side-effects/safest meds first. I worked my way through most of them without much improvement and ended up having a bowel resection. I have been on biologics now (along with other meds) for about 12 years and am holding my own.
I think the treatment routes have changed a bit, I think a lot of MDs now start with the stronger meds in hopes of remission and saving bowel and other (fistulas etc) from becoming a problem early on.
Good question, I look forward to hearing what others have to say.

 

[JaimeM]

i agree with above.. the quicker you can get into remission the less bowel is damaged

 

[my little penguin]

The top down therapy ( biologics first ) is growing
In kids they found the risk of surgery goes from 75% within 5 years to 30/40% with biologics
( not sure if adults )
Ds has been dx for over 4 years with 3 plus years on biologics .
Honestly far less side effects than the "safer" meds since they are finding out the Lymphoma risk was actually worse with 6-mo/Aza than remicade alone ...,

In the end it's all about what med gets you to complete mucosal healing and remission
Since all drugs can be deadly ( infant Tylenol - read the packet it can kill as well as amoxiciilan )
Risk benefits
Biologics have a ton of benefits IMO and let my kid be as normal as possible for as long as possible while saving his intestine from surgery

Good luck

Btw at dx I was afraid of all crohns meds including pentasa which is like giving aspirin for a brain tumor alone it's really not going to help much


It takes a while to accept treatments

 

[Scipio]

If you are asking which biologics the docs usually start of with, I'd say it's typically either Remicade or Humira, the two main anti-TNFs. Remicade is probably the more common because it has been on the market the longest and docs are most familiar with it.

Follow-on biologics for if and when the initial one start to lose effectiveness are Simponi or Cimiza (more anti-TNFs), or Entyvio (anti-integrin), or Stelara (anti-IL-12 and IL23 immune modulators). Tysabri (another ant-integrin) is also available, but its use has largely been replaced by Entyvio due to higher risk of serious complications for the Tysabri.

 

[Lizzie]

I am in the same situation, newly diagnosed with Crohns and the GI wrote to me suggesting starting biologics. I was utterly shocked, thinking biologics were the last resort, but I've done some reading and found, like people have said above, the current thinking is to use them straight away for moderate to severe Crohns in the hope of avoiding surgery. I'm still very scared and not looking forward to my appointment tomorrow when I actually see the GI and presumably have to make my decision.

 

[AliGilbreath]

Thanks for all of your answers. Lizzie I am in the same boat, worried and scared, but I am willing to do anything to feel better. I'm ready to start a treatment.

 

[Lizzie]

I've changed my mind a thousand times so far but yesterday when it came to the crunch I wimped out. You sound braver than me, Ali, if you feel ready to start the treatment. I've started on Entocort today instead. My GI was surprisingly understanding, though she strongly recommends biologics, but she said that quality of life is important and she realised that all the needle-related stuff would freak me out so much that for the time being she'll take a wait and see approach.

 

[JaimeM]

I started on entocort of 6 months and then went to remicade.. the entocort was great, but you get the reactions of steroids unfortunately.. i had such a puffy face during it.. but it provided relief and that's whats important. good luck to you

 

[cassimw]

Lizzie - Lots of folks taking Remicade, including a lot of little ones. My nearly 15 year old has had 3 treatments so far. She was just diagnosed 3 months ago and it was her first med. Just added 6-MP about a month ago. It's scary, but I did lots of reading and got lots of amazing advice on this forum and decided that it made the most sense for my daughter, who, by the way, prior to diagnosis was so petrified of needles! Now, she's totally used to them and hardly flinches.

Wishing you the best.

 

[Pam21]

I started off taking prednisone for first year I was diagnosed with uc and had ups and downs and recently in August got worse and then flare up stopped and then in November this year got so bad I had no other choice but to do remicade. It's working great my flare up has stopped

 

[ronroush7]

I was diagnosed back in 1990. It was a while before I was put on a biologic.

 

[Pam21]

Anyone take remicade and find that between infusions u r I'll or feel sick to stomach a lot my Dr says I'm only patient with this

 

[Pam21]

I was diagnosed back in 1990. It was a while before I was put on a biologic.

I was diagnosed when I was 18 and now 35 with so many ups and downs it's either really bad or really good

 

[ronroush7]

I was diagnosed when I was 18 and now 35 with so many ups and downs it's either really bad or really good

I hope things go good for you.

 

[ronroush7]

Anyone take remicade and find that between infusions u r I'll or feel sick to stomach a lot my Dr says I'm only patient with this

Does he think that maybe you are having a bad side effect? Maybe you should be on another biologic?