Humira Frequency Changes/Switching Biologics

[Jandersen20]

For anyone with experience in their child using Humira, if your child hasn’t really responded to biweekly injections since initial Crohn’s diagnosis, is it normal practice to increase the frequency to 10 days and wait, if no response increase the frequency again to weekly and wait before switching to a different Biologic?
Or, if not responding well to biweekly and then not responding to an increase of every 10 days, is it common to switch Biologics instead of trying another frequency increase?

 

[my little penguin]

Didn’t the doc just up the frequency to every 10 days last week ? And add Uceris foam the week before ??
It takes time to heal the gut even when meds do work
Gi land is slow to heal
Lots of watch and wait for months
No matter what the meds

 

[Jandersen20]

Yes, I’m just wondering next steps. I just like to know and understand the next steps and “what if” scenarios. I’m also just curious as to what most do if not getting good responses initially. I’m not talking about it works for a while and then it stops. I’m talking about not working well from the beginning. Is it common to keep increasing or stepping in sooner with a different Biologic. It’s just my curiosity

 

[Pangolin]

It took a while to figure out, but when we increased Remicade dose and frequency, we found that the side effects became worse and the inflammation itself became worse.

 

[Maya142]

We did a second frequency increase and added MTX at the same time. It worked but it did take months. I think 5 or 6 months. In retrospect, I'm not sure why we didn't give up on it - maybe because back then there were very few options (fewer than now). But I'm SO glad we stuck with it. Because then it truly worked like magic for my daughter and it gave her two great years before she had to switch (kids often get much longer than that - she is just a difficult case).

I think if he has had any response at all to Humira, it is worth sticking with it and seeing if it begins to help him more. And of course, you can always ask your GI at what point do you consider switching to another biologic. But do remember healing takes time - think weeks and months, not days.

Hang in there!

 

[crohnsinct]

Ifhis Humira dose was suboptimal at bi-weekly all the time he was on that dose does not count. They only start counting the time once he is at a dose where his levels are in a therapeutic range. Even then there is no hard and fast rule as to how long you wait before giving up on a drug.

What I can tell you is that you have the best shot at responding to your first biologic so docs will fight like crazy to get that biologic to work. Decreasing the interval, raising dose (not Humira as much as other drugs) adding other therapies (max, EEN etc).

Each doc has their own experience as to how long they feel a drug needs to start working. They will evaluate progress and if there is none or a slide backward then they will act. You could always ask the GI in the appointment, "what if" or "next steps?" But honestly we have been told those things and then the time comes and they pick yet a different path so I don't think the GI's even really know. Try to be patient and let the drug and disease do their thing. Honestly, none of those answers will make a difference to what you are doing now. There is no benefit for you knowing these things now except add to your obsessive researching. Not knowing is protecting your time and energy. Enjoy the holidays!

 

[Jandersen20]

Ifhis Humira dose was suboptimal at bi-weekly all the time he was on that dose does not count. They only start counting the time once he is at a dose where his levels are in a therapeutic range. Even then there is no hard and fast rule as to how long you wait before giving up on a drug.

What I can tell you is that you have the best shot at responding to your first biologic so docs will fight like crazy to get that biologic to work. Decreasing the interval, raising dose (not Humira as much as other drugs) adding other therapies (max, EEN etc).

Each doc has their own experience as to how long they feel a drug needs to start working. They will evaluate progress and if there is none or a slide backward then they will act. You could always ask the GI in the appointment, "what if" or "next steps?" But honestly we have been told those things and then the time comes and they pick yet a different path so I don't think the GI's even really know. Try to be patient and let the drug and disease do their thing. Honestly, none of those answers will make a difference to what you are doing now. There is no benefit for you knowing these things now except add to your obsessive researching. Not knowing is protecting your time and energy. Enjoy the holidays!

So very true. Thank you for your response!