Help on Humira fro Crohn's

[Coconut]

Hi
I am new to this website. My daughter has Crohn and has been diagnose 2 years ago. She has been for one year on Imuran. No results. then she was switch to Humira. After a year, the colonoscopy said that she had now mild disease, but she was in clinical remission. She has been asymptomatic for a year, beside the occasional headaches due to exam stress. We aklso had the calprotectin stool test: in april 320, august 640, october 670. The doctor put her on combination therapy with imuran. then we had th antibody level test done that came back low. So now the doctor wants to increase the dose to weekly instead of every 2 weeks .
I have concerns about the meaning of the drug level.. should we request the antibody to antibody test done fist without jumping? and do we care about the antibody level in the blood, we don't want the antibody in the blood we want it on the lining of the intestin?is it necessary to increase the dose if she is in clinical remission ans asymptomatic?
Did anyone goes through the same scenario?

Thanks

A concerned mother

 

[Clash]

Welcome to the forum.

With the antibodies levels test you want there to be no or low antibodies levels in the blood. Once there are high antibodies levels it means your body is fighting the med and making it ineffective. Also, there is a trough levels test to determine if the levels of humira in the body between injections is sufficient. The med/schedule can also be increased due to symptoms or lab work trending in the wrong direction, like the fecal calprotectin rising.

Clinical remission is the absence of symtoms and decent labs. With her fecal calprotectin rising it seems she isn't in remission. My son required surgery after being asymptomatic for a year or more on Remicade and mtx with normal labs. Simmering inflammation can cause irreversible damage.

I hope this answers your question.

 

[nitty]

That's a very helpful reply for me, Clash. I think I will be starting Humira in the New Year, so it is useful stuff to know.

Thanks

 

[David]

Clash hit the nail on the head. It also sounds like you have an excellent doctor who is monitoring disease state very intelligently. As Clash said, smoldering inflammation is very bad and your doctor is smart enough to know that. I think your daughter is in very good hands!

 

[Pilgrim]

Our daughter had a big fecal calprotectin jump in the summer. Without antibody testing (we were told they weren't reliable and our GI goes by symptoms, fcal, and labs) she was moved to weekly dose of humira. 6 months later she is feeling great, labs are good. Growing like a weed!

 

[Lady Organic]

I agree with previous posts, clinical remission is not enough. Chronic disease activity even if mild increases risks of complications for short and long term.