Entyvio Receives FDA Approval for Injectable Version

[Scipio]

Until now Entyvio has been by infusion only in the US:

https://www.fiercepharma.com/pharma/takedas-scores-second-chance-subcutaneous-version-entyvio

 

[lifeexperience]

@Scipio sorry to ask but I wonder if I could ask your advice on my post in this forum? My G.I asked me.. "what biologic do you want to try first?"

I have a lot of concerns about systematic side effects or even bad reactions some people have to biologics the first time.

I think perhaps Skyrizi or Entyvio is considered both the safest and most effective. I've had two G.Is I've seen in person tell me something like that.

My personal situation is I need to travel outside of the country.. sometimes for months at a time. I'm trying to see how I could get started on biologics and then continue with it while I'm overseas but most likely I would need to obtain the biologics in the U.S due to cost.

 

[Scipio]

@Scipio sorry to ask but I wonder if I could ask your advice on my post in this forum? My G.I asked me.. "what biologic do you want to try first?"

I have a lot of concerns about systematic side effects or even bad reactions some people have to biologics the first time.

I think perhaps Skyrizi or Entyvio is considered both the safest and most effective. I've had two G.Is I've seen in person tell me something like that.

My personal situation is I need to travel outside of the country.. sometimes for months at a time. I'm trying to see how I could get started on biologics and then continue with it while I'm overseas but most likely I would need to obtain the biologics in the U.S due to cost.

There is no one best biologic that generally works well for everybody. No two cases of Crohn's disease are exactly the same. A biologic that works great for one patient may utterly fail for another and vice versa. My own experience is only with Stelara - which has worked very well for me - in remission for six years and counting with no side effects.

As for Entyvio and Skirizi, the "word on the street" is that Entyvio works best for Crohn's located in the large bowel and Stelara works best for the small bowel, including the terminal ileum. But there are many patients who have been successfully prescribed these drugs the other way around, and both are fully FDA-approved for disease in both locations. Skrizi is still pretty new - too new for a consensus to develop, although it recently did beat Stelara in several factors in a head to head comparison clinical trial.

In terms of just flat out effectiveness in stopping the disease and restoring the gut to its normal healthy, pink appearance, the best (strongest) biologic is good ol' Remicade. But Remicade is also perhaps the most immunogenic, so it carries the highest risk of losing effectiveness over time due to development of anti-drug antibodies.

All the talk of side effects for biologics is IMO a bit overblown. The way I sum it up is the greatest health risk to Crohn's patients is not the risk of side effects from biologic drugs. The greatest health risk to Crohn's patients is the constant and lasting damage to the gut due to untreated or poorly controlled Crohn's disease. The side effects from biologic Crohn's drugs are real but very rare. The serious bad effects of uncontrolled Crohn's disease are real and very common.

 

[nofun]

All the talk of side effects for biologics is IMO a bit overblown. The way I sum it up is the greatest health risk to Crohn's patients is not the risk of side effects from biologic drugs. The greatest health risk to Crohn's patients is the constant and lasting damage to the gut due to untreated or poorly controlled Crohn's disease.

It took me a very long time to understand this and was stopping me from starting treatment. Another issue is the reported efficiency. For example Entyvio shows only 32% of patients achieving remission at 1 year vs 16% on placebo. Given the perceived risk and a small improvement over placebo explains why many patients decide not to go ahead. What the stats don't show is the possibility of a reduction of symptoms (not a full remission) that makes it worthwhile.