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inflectra —recurrent cellulitis

28 yo w Crohns (sm. intestine) well-controlled with inflectra (was on Remicade since 2014). Had a cellulitis in mid June requiring 2 night hospital stay for iv antibiotics. Cellulitis went away completely but now is back.

I’m mom and thinking he shouldn’t stay on inflectra w recurrent infections. Are there newer Crohns meds which are less immunocompromising?
The top biologics for Crohn’s that aren't anti-TNFs are Stelara and Entyvio. Each of these has a narrower, less immune suppressing effect on the immune system than inflectra.
I wonder if doctor would switch and if insurance (Medicaid) would pay for one of these if the reason is infections.
Id say stelera aka ustekinumab also, however they say the 1st biologic is the best after this they tend to not work as well, that makes it not so easy for us as a crohns patient as in my eyes we want the most effective medicine with the least side effects, there are more new meds coming, but what to give and in what order is going to be a real problem. and not being able to swap and change meds and being stuck on them in fear of them wearing of and generating antibodies at present.

And i think if your in trouble and having a flair you do not have time on your side, so they will go to what they know and what they trust is most powerful and of course this has most side effects.

There are people trying to work out ways to test patients for the best medicine before its given, i think it will happen but weather its in 5 years or 150 years i do not know.

And a cure could even come before this point.

But in terms of side effects stelera aka ustekinumab is a fairly groundbreaking med to date similar power to infleximab and least side effects from all meds.

my little penguin

Staff member
Govt insurance does cover Stelara if other cheaper options have failed
So if he has only been on remicade
I would assume humira would be required to fail as well before permitting Stelara.
Stelara has a lower overall infection risk per the infectious disease doc we asked
Fail is the key word

my kiddo had to fail remicade and humira before commercial insurance would cover Stelara
Even then it’s still a battle for re approval