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Entyvio - How Long

My daughter recently switched to Entyvio from Remicade (lost response). She has finished her loading doses and is due for her first maintenance dose this week. She is on an every 4 weeks maintenance schedule. So she is in her 9th week.

She is flaring badly. Has had 3 hospital admits in the past 4 weeks for a total of 14 days. She is on triple antibiotic therapy and prednisone to get her to that magical Entyvio kick in point, however, during her last admit they had a surgeon come talk to her about the possibility of a colectomy. She was discharged yesterday and seems to be struggling again.

My question is, how long did it take to kick in for you all? Did you notice gradual improvements? If so, starting when?

Also, she is getting these crazy fevers that we are chalking up to Crohn's inflammation but I think I read somewhere that some people on Entyvio complain of fevers. Does anyone have this? If so, is it just during infusion, the week after or all the time?
 
Hi crohnsinct,
I’m so sorry for your daughter and hope she’ll feel better soon.
Entyvio takes usually 3/4 months or even more to fully kick in.
I never heard of fever from entyvio, you may want to check it with her doctors.
Prednisone doesn’t help either?

How old is she? Maybe an elemental nutrition could help too till entyvio kicks in
 
Yeah. Her GI is saying 12-26 weeks. She is getting her first maintenance dose next week.

Yeah, prednisone isn't working so well. In the hospital she was getting iv prednisone and TPN. She got discharged on 30mg oral. She is 19. I am trying to convince her to do een. She did it before and it worked like a charm but she wasn't this sick.

The waiting is a bear. I would settle for just a little sign right about now.

Thanks.
 

my little penguin

Moderator
Staff member
VEDOLIZUMAB
Vedolizumab appears to have a generally slower time to response compared to other biologic agents. This may relate to the mechanism of anti-integrin therapy, with inhibition of lymphocyte gut migration taking more time to achieve therapeutic efficacy[73].
Time to response
CD: Clinical remission with vedolizumab appears to take at least 10 to 14 wk in CD. This slower onset of action of vedolizumab, compared to anti-TNF therapies for instance, was evident in the RCTs GEMINI 2 and 3 registration trials of vedolizumab comparing therapy to placebo induction and maintenance therapy in CD[74]. Clinical remission rates increased from 15% to 27% between weeks 6 and 10 while remained stable in the placebo group (12%) at these time points in GEMINI 3 (i.e., those with prior anti-TNF failure), and in GEMINI 2 there was a significant increase in clinical remission after 6 wk compared to placebo[73]. Subsequent real-world observational data have also demonstrated that clinical remission rates tend to increase from week 6 to week 14 and in one study the median time to clinical response was 19 wk[75]. Mucosal healing rates of 30% were attained after a median of 22 wk in CD in one observational study[76]. Furthermore, GEMINI 2 found that almost 40% of initial vedolizumab responders remained in clinical remission to 52 wk although clinical remission rates only became superior to placebo after 30 wk[77].
UC: Response and remission rates appear more rapid in UC than CD. At week 6 after a 2-dose induction, clinical response, remission rates and mucosal healing were significantly higher with vedolizumab than placebo (47%, 17% and 41% vs26%, 5% and 25% respectively) in one RCT[78]. Moreover, maintenance vedolizumab resulted in higher rates of clinical and endoscopic remission at week 52 than week 6 and mean partial Mayo scores continued to decline until week 52, suggesting that maximal response often takes several months.
Therapy-related factors affecting time to response
While immunomodulators appear to reduce the formation of antidrug antibodies to vedolizumab[78], the low proportion of patients who actually formed antidrug antibodies in trials might imply that combination therapy may be unnecessary and hence may not provide additional benefit to time to therapeutic response, in contrast to anti-TNF therapies[78].

From



Time to clinical response and remission for therapeutics in inflammatory bowel diseases: What should the clinician expect, what should patients be told?
Abhinav Vasudevan, Peter R Gibson, and Daniel R van Langenberg


So minimum of 19 weeks for most people with UC
And longer for crohns patients

End point of 12 months whether it works or not
🥺

Hope she responds soon
 
My daughter recently switched to Entyvio from Remicade (lost response). She has finished her loading doses and is due for her first maintenance dose this week. She is on an every 4 weeks maintenance schedule. So she is in her 9th week.

She is flaring badly. Has had 3 hospital admits in the past 4 weeks for a total of 14 days. She is on triple antibiotic therapy and prednisone to get her to that magical Entyvio kick in point, however, during her last admit they had a surgeon come talk to her about the possibility of a colectomy. She was discharged yesterday and seems to be struggling again.

My question is, how long did it take to kick in for you all? Did you notice gradual improvements? If so, starting when?

Also, she is getting these crazy fevers that we are chalking up to Crohn's inflammation but I think I read somewhere that some people on Entyvio complain of fevers. Does anyone have this? If so, is it just during infusion, the week after or all the time?
Entyvio can cause chills and fever, severe diarrhea, fatigue and more flu-like symptoms and poses a remote and rare risk for PML.

Antibiotics only serve to weaken the GI tract more by creating a leaky gut.

Please get a second and if necessary a third opinion as to your daughter's options. And if her GI doctor has not put her on a low-residue (fiber) and non-dairy diet and/or has not addressed her psychological stress levels, then you may want to consider getting a new doctor.

I am still in a flareup, but there are people with IBD who have benefitted from the Carnivore diet.
Also, please look into "anti-nutrients" because they DO exacerbate GI problems.
 
Please do a keyword search on this forum for "Entyvio side-effects" to confirm your daughter's symptoms. Also, some of the side-effects from the Prednisone can overlap with the Entyvio, especially during a Prednisone taper.
 
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