Doctor said cimzia antibodies unlikely

[nogutsnoglory]

One of my doctors said that I wouldn't need to be on an immunosuppressant in addition to cimzia. He said they combine them with remicade because it has mouse protein and humira and cimzia are human proteins.

Why are so many doctors combining meds for humira and cimzia if its unlikely to develop antibodies.

 

[rollinstone]

well im no doctor, but i always thought the body could form antibodies to most medicines hence why the combine the two, but then again, why do some immunosuppressants stop being effective for some people? i am very much intrigued myself, either way I hope cimzia works for you!

 

[David]

Antibodies to Cimzia and Humira can definitely develop though I'd avoid the immunosuppressant if that's what your doctor suggests.

Immunogenicity

Patients were tested at multiple time points for antibodies to certolizumab pegol during Studies CD 1 and CD2. The overall percentage of antibody positive patients was 8% in patients continuously exposed to CIMZIA, approximately 6% were neutralizing in vitro. No apparent correlation of antibody development to adverse events or efficacy was observed. Patients treated with concomitant immunosuppressants had a lower rate of antibody development than patients not taking immunosuppressants at baseline (3% and 11 %, respectively). The following adverse events were reported in Crohn's disease patients who were antibody-positive (N = 100) at an incidence at least 3% higher compared to antibody-negative patients (N = 1,242): abdominal pain, arthralgia, edema peripheral, erythema nodosum, injection site eryhema, injection site pain, pain in extremity, and upper respiratory tract infection.

The overall percentage of patients with antibodies to certolizumab pegol detectable on at least occasion was 7% (l05 of 1,509) in the rheumatoid arthritis placebo-controlled trials.

Approximately one third (3%,39 of 1,509) of these patients had antibodies with neutralizing activity in vitro. Patients treated with concomitant immunosuppressants (MTX) had a lower rate of antibody development than patients not taking immunosuppressants at baseline. Patients treated with concomitant immunosuppressant therapy (MTX) in RA-I, RA-II, RA-II had a lower rate of neutralizing antibody formation overall than patients treated with CIMZIA monotherapy in RA-IV (2% vs. 8%). Both the loading dose of 400 mg every other week at Weeks 0, 2 and 4 and concomitant use ofMTX were associated with reduced immunogenicity.

Source

 

[nogutsnoglory]

The problem is my rheumatologist says antibodies are unlikely but the GI says I would need something like 6mp or Imuran as well.

Both deal with biologics for patients but I guess I need to go with my GI.

 

[David]

The GI wants to add 6mp or Imuran to stave off antibody formation or because they feel your disease state is serious enough that you need additional treatment?

 

[nogutsnoglory]

I think more along the lines to prevent resistance to the biologic. I hate the idea of taking another heavy duty medication but at the same time the prevailing wisdom seems to be in favor of combining.

 

[David]

Have you already tried Remicade and Humira? If so, what happened with those? Have you been on an immunosuppressant previously?

 

[nogutsnoglory]

I have tried humira with a bad allergic reaction. I was on 6mp which didn't do much for me since I ended up in surgery. I have had more luck with steroids and antibiotics but those are more temporary.

 

[Crohn's Mom]

Our GI explained that the reason they are going to combo therapy more, is due to the findings in the SONIC trial, and the 6mp/imuran combined with the Biologic is helping the Biologic to be more effective.