Optimizing the use of anti tnf

[crohnsinct]

Excellent read! Addresses many of the issues we discuss on a daily basis here.


http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4416970/

 

[pdx]

Thanks--good article. I was discouraged by the stats on remission after a year: only 1/3 of patients using anti-TNF therapy remain in remission at the end of the first year?

I thought it was very interesting that the authors so strongly recommended levels testing to guide dosing, and even showed evidence that it saved money over empiric dosing. It's frustrating that so many of us have troubles getting levels tests (and similar tests like FCP, that can help guide treatment) covered by insurance, when they not only aid in treatment decisions, but also help save money in the end.

 

[crohnsinct]

Right! We sent this stuff in with our appeal on the levels testing. Will see where that gets us.

I don't take those remission rates as gospel. If you just look around here I would say our remission rate after 1 year is over 1/3rd. Just enjoy the remission while you can and remember that adding an immunosuppressant can help extend that out. Maybe my daughter's diet has helped her but she has been in remission almost three years now. Her doc has also done everything listed in the article.

 

[crohnsinct]

This might help you feel better.

http://www.ncbi.nlm.nih.gov/pubmed/25911120?dopt=Abstract

 

[pdx]

Yep, that one does make me feel better--thanks!

 

[my little penguin]

That ones makes me feel better
Of course I am thinking it applies to humira as well

 

[Tesscorm]

Great article! Thanks for posting.

 

[Worried mama]

My son had his 4th remicade treatment 2 weeks ago and we met with dr today. Dr just told us he did level testing, we didn't even know or ask for it, but based on the results, we are increasing his dosage...I didn't even realize until today that this was a thing. Glad our dr. Is on top of it!

 

[Mr chicken]

Ds never got to 5 mg/kg at every 8 weeks
After induction therapy he had to stay at 7.5 mg/kg every 6 weeks

This last for 8 months until he reacted but he wasn't on mtx then

So far so good on Humira/mtx

 

[pdx]

E's doctor bumped her Remicade dose up to 7 mg/kg today, due to low trough levels at her previous two infusions. We were happy about that, although the rest of the infusion day was a bit of a trainwreck, involving 2 phlebotomists, many IV attempts, Atavan, no successful lab draws, and 8 hours in the hospital. The infusion got done in the end, though, and everyone is feeling better now that we're back home.