Entyvio & Rinvoq Combo

[Whisperings]

Hey all, I recently had a colonoscopy that showed markedly active and chronic inflammation in my terminal ileum, and so my doc is changing my medications. I've been on Rinvoq for about a year now, but started to have symptoms reappear as of this summer. Now, we're adding on Entyvio infusions starting later this month. I'm a bit nervous to be on two really strong medications, and I was curious if anyone here has been on this combo or something similar?

 

[Crohn2357]

I would rather add high dose of Stelara or remicade instead of entyvio.

 

[Whisperings]

Thanks for your reply - I actually failed Remicade already, along with Humira and Skyrizi. That might be why we're leaning towards Entyvio now? But can I ask what concerns you most about Entyvio?

 

[my little penguin]

Entyvio is known for working in the large intestine -not the small intestine .
Stelara is known for the small intestine.
When you say failed .. how long were you on skyrizi and at what dose ?
My kiddo takes Stelara
But in order for it to work he takes 90 mg every 4 weeks .
Every 8 weeks did nothing .
Also have you gotten a second opinion ?
Harder to treat cases sometimes need fresh eyes.
Any immunology testing done ?

FWIW my kiddo is on two biologics plus mtx
Stelara plus mtx for crohns and juvenile arthritis
Plus a second biologic for a separate auto inflammatory condition.
He has done this for many years
It works so …that is what he uses

 

[Whisperings]

Ah...I had no idea Entyvio works best in the large intestine in comparison to the small bowel. I should ask my doc about that, I'll be seeing him later this month. Looking back, it looks like it was 360 mg/2.4 maintenance dose? I was on it for 4 months but got so sick - felt like I was on no meds at all. I know my doctor was trying to wait and see if it would kick in but it didn't seem to. So we switched me to Rinvoq, which induced remission for about half a year until I started having symptoms again.

What would immunology tests be? Is that looking for antibodies - can that be done for rinvoq?

 

[Whisperings]

360 mg/2.4 maintenance was the Skyrizi dosing to be clear!

 

[Crohn2357]

can I ask what concerns you most about Entyvio?

This explains it:

Entyvio is known for working in the large intestine -not the small intestine .

 

[Nadia96]

I was placed on entyvio after I had my large bowel removed and that made my Crohn’s a lot worse. I was in and out of hospital and now I know that because it doesn’t work for the small bowel. However at that time my doctor who did a lot of research and trials for IBD, said that I had to be on it before I can get stelara. At that time stelara had only just been approved for Crohn’s disease here in the UK. And to get approval from NHS England, we had to have had tried all other biological before considering stelara and even then he still had to get approval, it just makes it a bit easier.

 

[Domino300]

I had an ileostomy for UC in 2008. No large intestine. Had blockages in small bowel starting in 2019, diagnosed with Crohn's in 2023 after hospital time with severe blockages. I've been on Entyvio for a year and a half with no problems, no sickness, can eat anything, so I am confident it works for me.

 

[Crohn2357]

I've been on Entyvio for a year and a half with no problems, no sickness, can eat anything, so I am confident it works for me.

How much time after starting entyvio did your inflammation markers normalized and blockages resolved?

 

[Domino300]

I put off starting entyvio for a couple months, unsure about it. Started getting cramps again, so I had first infusion and many more since. The only problem I've had is the strictures/blockages. When I had UC I had much bleeding, mucous, cramps etc. No bleeding/cramping from small intestine since infusions.