Humira vs Remicade?

[firebob]

I have had IBS issues for years, but was never able to get a doctor to do any testing.

Last year I ended up in the hospital for 5 days after bleeding, pain, and lack of energy that had been going on for 6 weeks. The CT scan showed 2 diverticula at the trouble spot so i was treated with lots of IV antibiotics and got some what better.

It took a few months to get an MRI with contrast and colonoscopy. I'm being told the test results don't show for sure that it's crohn's. I have been on Lialda for 4 months (don't think it dose anything), I'm on my second round of prednisone (Slows down the bleeding and lightens up the pain), and 3 rounds of Cipro / metronidazole (I feel great after a few days then feel the same after finishing the drugs).

I have done a lot of diet changes and found long fibers kill me.

I went to the doc this morning. I told him i was to the point i wanted to try a full liquid diet, but he thinks this will land me in the hospital after a few days.

He wants me to go on Humira or Remicade and to let him know first thing Wednesday morning so he can get insurance working on it.

I have done a lot of reading, but I'm not sure. The pain of the shot or spending half a day in an IV center dose not bother me.

I'm over weight and have been dropping about 20 pounds a month except the months i have been on prednisone where i gain 20 pounds a month. I'm around 330 pounds right now.
I have also been told that i have around 20 cm of healthy colon.

What would you do?

 

[FrozenGirl]

Honestly it's kind of a 6 in one hand, half a dozen in the other hand type issue.

It's pretty what works for you. With Humira you also have to consider pharmacy stuff, are you willing to make sure you are home for delivery and able to store it promptly. With Remicade you have to consider more scheduling. Depending on how busy your infusion center if you might not be able to choose a time that's good for you as much as be given a time. If you travel Humira might be better for you as you can travel with it (I believe they will send you a cooler for travel). Also check out where you would get your Remicade, is it close/convinient .

Basically if you don't have fistulas they are pretty equal. Good luck choosing.

 

[firebob]

Well i never thought about the fact of having to be home to get the Humira in the mail or bad he scheduling is at the infusion centers with Remicade.

Working night shift i could just sleep in the living room the days the Humira comes in the mail. I called the only 2 infusion centers around me they are both over booked from the sounds of it so a set schedule would not work for me.

Thank you for the much needed reality check.

 

[FrozenGirl]

Your welcome. I'm on Remicade and the med is great but the infusion clinic gets more and more packed. In actually on the 4th location move due to needing a larger space and it's not nearly as easy to get good appointment times which is unfortunate.

It sounds like Humira might be the best choice for you.

 

[firebob]

It looks like i will do the first loading dose in about 10 days. Still working out all the odds and ends.

 

[aypues]

Humira is super easy...very little pain with the pen. Just some mild soreness after for a day. They will send a Humira "ambassador" (a nurse) to teach you how to inject if your doctor doesnt. It comes from the specialty pharmacy in a huge styrofoam container on ice...it will stay cold 3 days they said. There are no worries with rushing home to accept it or anything. Btw, you can travel with it unrefrigerated for up to 14 days.

 

[Layla]

Humira is super easy...very little pain with the pen. Just some mild soreness after for a day. They will send a Humira "ambassador" (a nurse) to teach you how to inject if your doctor doesnt. It comes from the specialty pharmacy in a huge styrofoam container on ice...it will stay cold 3 days they said. There are no worries with rushing home to accept it or anything. Btw, you can travel with it unrefrigerated for up to 14 days.

And I find less pain using a syringe rather than the pen. It might pay to try both the pen and the syringe to see what you prefer. I also don't get it delivered, I just go to the pharmacy when it suits me and pick it up. I don't even think delivery is an option here in NZ. I get 2 at a time so have to go to the pharmacy once a month, is that not an option in the US?

 

[aypues]

In the US we have multiple payers, so it would depend on what the insurance company dictates.

 

[firebob]

I called my insurance and they told me to use there specialty pharmacy.

A few scrips were sent Wednesday. One of the pharmacy workers did not read them and sent in the maintenance dose to insurance to be approved. I called Friday to see what was up and the computers were down most of the day. When I did get a hold of them it was after 4:00. They were going to submit the first starter dose, but they say the Doc office did not fill out all the information on that one scrip (i call BS).


***rant***
I know i just work as a CNA.
I see people die all the time because docs order every test in the world before they start treatment for something that is obvious.
I see people die, get sicker, or have to go to the ER because the pharmacy is not able to fill and ship stuff like blood presser meds even after you ordered them 5 nights in a row.

Sorry for the rant.