Humira vs Remicade

[jane.hartshorn]

I've been on Humira for around ten weeks - injection every two weeks. I noticed an improvement in my symptoms immediately, however this only lasted for around 3 weeks before my condition returned to its previous state.

I saw my consultant today and he is keen to proceed with surgery. This was quite a shock to me as I have had Crohns for around 15 years and my condition has only deteriorated in the past 10 months. I am currently taking azathioprine and clipper steroid plus Humira. Before my relapse I was intermittently taking azathioprine, however I had no symptoms and was put on azathioprine in order to prevent any future/potential symptoms.

I suggested I try Remicade, but my doctor seemed to think that as Humira is the stronger of the two, Remicade won't work.

Has anyone else got any experience of something similar? Has anyone else changed from Humira to Remicade and found it to work? Has Humira taken any longer than ten weeks to work? Also, has anyone been put on any alternative medication? My doctor said that this kind of medication is the last stop before surgery....I am very very reluctant to have surgery, however, until I have tried everything.

 

[Clash]

I've not heard that Humira was stronger than Remicade in fact I think there are some studies that show that Remicade had a higher efficacy.

Here is a good study on switching biologics

http://www.crohnsforum.com/showthread.php?t=42119

 

[lgpcarter]

Remicade worked for me, but Humira didn't. I also don't think one is stronger than the other, just different.

Personally, I would give Remicade a try before surgery.

 

[KayleighMeek]

I have been on both remicade and humira for me remicade worked a lot better than humira. I had to go up to weekly doses of humira and it still wasn't as good as remicade. Maybe you could try weekly humira to see if that makes a difference?
I have now started cimzia which is for arthritis and is being used for my crohns arthritis, it is helping a lot with the crohns too. I have just completed my second loading doses and it is working so much better than humira and I would say nearly as well as remicade for me.
The only problem is that is not licensed for use just in Crohn's disease yet (but it is in America) so it is convincing your GI to go along with it which can be difficult.
Hope this helps a bit x

 

[lblair]

Hi Jane

I noticed the same thing on Humira but I'm currently on once a week injections and steriods but currently the small bowel is bleeding again had a ER visit on Tuesday and know the GI wants to see me.

What kind of surgey are they thinking???? My dr told me that Remicade and methotraxade would be next after Humira for me I'm so confused!!!!!!!!

Good luck!!!!!

 

[jane.hartshorn]

Hi there,

Thanks for your comments.

What's methotraxade? When I asked him what surgery would entail, he said bowel removal with a stoma. I am very worried about this, as I feel I have not tried different types of medication. Do you think changing my other meds might help? I have never found azathioprine to be effective...even when my symptoms were less severe. Because I have been in pretty much a stable condition for the last decade or so, I haven't tried changing my diet or anything either. However, because I am now so consistently ill, it's too difficult to detect if I should be avoiding certain foods.

I'm just not really sure what to do and how to take the situation into my own hands!

Jane

 

[KayleighMeek]

Methotrexate is another immunosuppresant it can be taken orally or by injections.
I am also on oral methotrexate and it has worked really well for me. It is used in crohns usually after people have tried azathioprine or 6 mecaptopurine. It is also used in treatment for arthritis along with a lot of other conditions and has been around for a long time.
Some people struggle taking methotrexate tablets as it can make you feel very sick I and this for the first couple of months but they gave me omzoprezol which got rid the sickness however some still can't tolerate the tablets and have injections instead.

 

[KayleighMeek]

Has the dr given you a specific reason why they want to do surgery? Have you got any strictures?

 

[jane.hartshorn]

No, he just said that humira was the last resort before surgery. I don't even know what a stricture is! This was the first time I've seen the consultant in 8 months as there haven't been any appointments available. I managed to see a specialist nurse at the hospital who put me on the humira but she's been off for the past two months, and so my condition has been going unmonitored. I was pretty shaken today upon hearing that surgery is now the next step, and so decided to find a forum like this to see what other people think!

Jane

 

[KayleighMeek]

I would really try and speak to your GI more and see why he wants to resort to surgery before trying other medications if that is what you want to try. Maybe you could see about getting a second opinion as well so you weigh up all the possibilities, personally I think this is the route I would go down if I was in your position at least then you can have all the information to make the right decision for you.
You can have strictures of your bowel which cause it to narrow this can be due to inflammation which can be treated with medications and will get better.
Sometimes you can have strictures that are caused by scar tissue and the only way to get rid of them is surgery but it doesn't always mean having a stoma, a lot of people have bowel resection and go on to make a full recovery with out ever needing a stoma.
I hope you can find something that works for you and get a supportive GI

 

[KayleighMeek]

Forgot to put I have not had to have surgery so far and I have been through a lot of medications just because one doesn't work doesn't mean that others won't.

 

[Toffey2shoes]

Hi Jane

I have had Crohns for 50 years...in the early days I had a lot of surgery.....6 times.......but as they cut out pieces of the ileum, crohns came back in the so called neo ileum .....usually came back three year after surgery.....lol gave up on surgery

Agressive use of Prednisone...still on it..for the last ten years i have been on Remicade as well ......and had many years of relief..but for the last year not seems to be working

My gastro guy now wants me to add Imuran to the daily intake and switch from medicaide to Humira.............that is why I joined this group today to read up on other experiences with these drugs.

Before the surgery decision make sure you find out WHat kind Of Surgery...to which part of gut and talk to as many persons as possibe

hang in there.......We can all live with Crohns keep the faith

 

[lgpcarter]

Surgery seems like a pretty drastic step at this point, or if it is needed, at least your GI should explain a little better about exactly why it is and more about what the surgery would involve. I think a second opinion is definitely warranted, or a firm request from your current doc to try other drugs before you have surgery.

Methotrexate is used both on its own and with Remicade and Humira. Might also be worth asking about.