Crohn’s treatment with TWO biologics?

[Manzyb]

Hello!

has anyone been prescribed TWO biologics at once to help heal their Crohn’s?

 

[momsa]

Were you, or are you just asking whether this is possible? I've seen studies in the literature that show that this can sometimes be effective, but I don't know how we would get past the insurance barrier, do you?

 

[Jo-mom]

I believe @crohnsinct and @Maya142 have some experience with two biologics with their daughters. Perhaps they can provide some insight.

 

[crohnsinct]

My daughter was on Entyvio and Humira. In the US it is easier to get two biologics through insurance if one is infusion and the other injection. The injection will go through pharmacy benefits and the infusion through medical and sometimes the two sides don't talk.

 

[Manzyb]

Were you, or are you just asking whether this is possible? I've seen studies in the literature that show that this can sometimes be effective, but I don't know how we would get past the insurance barrier, do you?

My doctor wants me to give Entyvio a second try along with Tremfya. She said that it would be a safe combination, but it makes me nervous! I was just curious if anyone had experience with taking two biologics!

 

[Manzyb]

My daughter was on Entyvio and Humira. In the US it is easier to get two biologics through insurance if one is infusion and the other injection. The injection will go through pharmacy benefits and the infusion through medical and sometimes the two sides don't talk.

That would be wonderful! I’m taking Tremfya and use to do entyvio, but we are going to try them both to see how it goes. Although Tremfya isn’t approved for crohn’s it’s showing great results in clinical trials.

 

[my little penguin]

Two biologics here but one is for auto inflammatory disease and Stelara plus mtx for ctohns
My kiddo has been on two for many years now without issues

 

[DougUte]

Hello!

has anyone been prescribed TWO biologics at once to help heal their Crohn’s?

No.

What biologics are involved? When Tysabri was being studied for use in Multiple Sclerosis, a study of use with another biologic resulted in 3 deaths. I would be very weary about taking 2 biologics at once.

 

[Scipio]

Two papers on the question of using two biologics:

Efficacy and safety of simultaneous treatment with two biologic medications in refractory Crohn's disease - PubMed (nih.gov)

https://pubmed.ncbi.nlm.nih.gov/34602905/

 

[Manzyb]

No.

What biologics are involved? When Tysabri was being studied for use in Multiple Sclerosis, a study of use with another biologic resulted in 3 deaths. I would be very weary about taking 2 biologics at once.

Tremfya and Entyvio are the two I would be on.

 

[Manzyb]

Two biologics here but one is for auto inflammatory disease and Stelara plus mtx for ctohns
My kiddo has been on two for many years now without issues

Thank you! What biologic are they taking along with Stelara?
We are looking at Tremfya and Entyvio. There is just not much info out there.

 

[my little penguin]

ilaris and Stelara

 

[Maya142]

My kiddo has been on two biologics too. But in her case, one was for her severe inflammatory arthritis (Ankylosing Spondylitis) and the other for her Crohn’s. She’s done Cimzia with an IL-17 inhibitor, Cimzia with Rinvoq (JAK inhibitor like Xeljanz/ Tofacitinib) and actually, we are likely going to try Tremfya with an anti-TNF next.

Can I ask - what dose of Tremfya are you on? Were you prescribed it by your GI or another doctor?

 

[Manzyb]

My kiddo has been on two biologics too. But in her case, one was for her severe inflammatory arthritis (Ankylosing Spondylitis) and the other for her Crohn’s. She’s done Cimzia with an IL-17 inhibitor, Cimzia with Rinvoq (JAK inhibitor like Xeljanz/ Tofacitinib) and actually, we are likely going to try Tremfya with an anti-TNF next.

Can I ask - what dose of Tremfya are you on? Were you prescribed it by your GI or another doctor?

I was prescribed it by dermatology because I have severe plaque psoriasis as well. They could only get Tremfya 100mg every 8 weeks approved by my insurance. It’s my understanding that a much higher dose is needed to treat Crohn’s, but since it’s not approved, my GI can’t make a case that the insurance will accept

 

[DougUte]

Tremfya and Entyvio are the two I would be on.

I'm on Entyvio alone right now. I've had good results from that. I'm not familiar with Tremfya.

 

[my little penguin]

If it’s psoriasis??
Just a thought
Why not just Stelara at the crohns dose ?
Stelara is approved for both

 

[Maya142]

Yes - you may have better luck with Stelara since the Crohn’s dose is much higher than the psoriasis dose. 90 mg every 8 weeks for Crohn’s dose which can be increased to every 4-6 weeks, vs. 45 mg every 12 weeks for psoriasis.