Remicade not working anymore?

[eneg16]

I’ve been on Remicade for the last year and a half and for the first year and few months it seemed to be working fine. However the last few months I’ve been having the same pain and fistula drainage and pain that I had prior to starting remicade. I’m afraid that it’s not working anymore. I’ve recently been increased from every 8 weeks to every 6 weeks but it still seems like my disease is breaking through way before my next infusion.

Has anyone experience their Remicade (or any other biologic) stopping working. What were the signs you had?

 

[ronroush7]

I have been on several biologics. Everyone is different. Cimzia has been the most successful so far but then the symptoms returned. Call your doctor. He may have to switch biologics on you.

 

[Scipio]

It's common for biologics like Remicade to lose effectiveness after a while. What usually happens is that your body starts to make antibodies against the Remicade protein, blocking its effectiveness. The usual approach to deal with this is to increase the dose, which is what they are doing with you by shortening the time between doses. If that doesn't work or doesn't last then the next step is usually to switch to an different biologic.

Also, sometimes immunosuppressants such as methotrexate or azathioprine are given along with the biologic to reduce the body's ability to make antibodies against the biologic, which prolongs its effectiveness. Ask you GI about this possibility, especially when and if you switch to a new biologic.

 

[crohnsinct]

Are symptoms breaking through at a specific point in the cycle or is Remicade never making you feel better? If it works but only for a short while, it could be that your body is metabolizing the drug quickly. They can actually move infusions to as frequently as every 4 weeks and up to 10mg/kg...depending on what your insurance will approve. A good way to tell if increasing the dose or shortening interval will work is taking a levels test right before the next infusion. If your level is not at therapeutic levels then they just increase or shorten or both. They will also test for antibodies at the same time. If you are building antibodies they can add methotrexate but if the antibody level is high enough they will switch you to another biologic. If you have sufficient levels and no antibodies, you may have just lost response. This happens. My daughter has been on Remicade for 6 years, no antibodies and it is looking like she is losing response. It is just never working anymore. We are giving it one last ditch effort with 10mg/kg every 4 weeks for 4 months. If this doesn't work we are moving on.