Remicade vs Humira

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Atlantic

Joined
Jan 30, 2017
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Gastro Dr told me during last visit he recommends Remicade Infusions every 8 weeks. Also said Humira injections every 2 weeks is an option. On Pentasa for last decade. Currently 8 capsules a day. Had self reduced this amount for several years because was not having many issues and do not like taking meds if can avoid. I started experiencing more episodes 6 months back and Dr increased to 8 a day. I thought have been doing fairly well with limited major episodes of severe cramping over last few months. But while not having major "sick" cramping spells, I was getting weekly more of mild stomach aches. Told Dr this last visit 3 weeks ago and he suggested Remicade or Humira. I was not happy to here this because I see all the possible side effects. Hate to create a new body problem issue by taking a med to fix something else. Also the thought of jabbing myself every other week or sitting for hours with an infusion the rest of my life is not sitting well. I do have a lot of denial of having a disease. I have told Dr I will think about what he is recommending. Really was in shock and didn't ask a lot of questions. Thinking I might prefer to bear thru the weekly gut issues as opposed to having to take injections or infusions of major drugs. Anyone have tips/advice? Is there other options that don't require all these injections? Which one of these drugs would you recommend if have to take one- Rem/Hum? Thanks so much.
 
Good Day A,
sorry for your struggles.

I would first try to come to terms with the fact that I will most likely
work-through both of those drugs + next drug.

Second, since you asked how I'd do it...
I would take Remi first in sequence before Humi.
Remi has a hint of mouse, which slightly diminishes outcomes for some?

Next stop, the Humi express, which is all human sourced, and thus often touted
as more readily tolerated over the passing of time.

Remi came first.
Explore & exhaust Remi first.
Humi came next.
try that next.

Beyond that...
tease your mind a sneak preview...
try to deliberately start making friends with these new elements, including...
that next drug then comes next for you.

It's good until it isn't, then = next treatment to try!

A favourable (in Canada we like extra "u"s) response can prove
a tricky & ellusive thing, particularly as time goes by.
The build-up of antibodies can render the biologic less effective,
or even ineffective over time. - moving targets in a fading game


Have you been formally diagnosed?
wishing you only well,
peace
w

ps
I believe phases of denial are a healthy part of this unhealthiness!
The key is to move-through denial.
keep trying to open yourself to the current ever-evolving realities
: D
 
I have had both. With the Remicade, I had to go to an infusion center for a few hours while they gave me the Remicade. With Humira, I give myself the injection. I can't tell you which one to try. Different people respond differently. Best of luck.
 
I have 2 daughters with Crohns. One is in long term remission on just 6MP the other is on Remicade/6mp. I would recommend going with Remicade first as the Humira shots are painful. The chemo center my daughter uses has a fast infusion method that takes one hour. Make sure to use an immunomodulator like 6mp with the Remicade to help avoid antibodies. It may not seem like it but I think Remicade infusions are way more convenient then Humira.
 
I tried Humira first and that was a mistake. I switched docs and now am at a full IBD clinic/specialist. She put me on Remicade. It worked immediately. I was in shock and still am, frankly. I take it in combination with Cellcept. Others take it in combination with 6mp/azathioprine or Methotrexate to reduce the chances of autoantibodies to the Remicade, and it makes it more effective. Remicade is the most studied and is actually the most effective of the TNF blocker class of medications for Crohn's.
 
Well everyone is different and I had an immediate (good) reaction to Humira, but sadly it didn't last. I'm now on Remicade which hasn't been doing anything much for the last 4 months but the last few weeks have been good so hopefully it's finally starting to work.

I much preferred taking Humira as I could do it in my own time. Yes it hurt but they've changed the formulation and apparently it doesn't hurt anymore. This new formulation may not be available in the US yet but it will be coming soon.
 
I tried Humira first. Having had both the pen and syringe, with the old formula and the new, I can say that I now inject with the syringe every fortnight and hardly feel a thing.

To me, the thought of having to go to hospital and spend hours having an infusion (the infusion may not take that long, but all the waiting around and checking in and general time taken, including travel, parking etc...does) would make me feel more like a sick, dependent person than being able to quickly treat myself in my own home.

Also, the fact that Humira is a closer match to the human body than Remicade was more appealing.

I didn't respond straight away to the Humira, but after a quick course of steroids it has kept me in remission so far (been on it just over a year now). I have had less side-effects on Humira than I had on Azathioprine, but that is just my experience.

Have you got the option to consider any of the drugs inbetween, like 6MP or azathioprine? Many people manage very well on those drugs. For me, even though I couldn't stay on the azathioprine, it was probably a good step psychologically for me to then realise that the stronger drugs are an unfortunate necessity.

Please don't carry on doing nothing though. Untreated disease will almost inevitably cause you more problems in the long run.
 
nitty said:
I tried Humira first. Having had both the pen and syringe, with the old formula and the new, I can say that I now inject with the syringe every fortnight and hardly feel a thing.

To me, the thought of having to go to hospital and spend hours having an infusion (the infusion may not take that long, but all the waiting around and checking in and general time taken, including travel, parking etc...does) would make me feel more like a sick, dependent person than being able to quickly treat myself in my own home.

Also, the fact that Humira is a closer match to the human body than Remicade was more appealing.

I didn't respond straight away to the Humira, but after a quick course of steroids it has kept me in remission so far (been on it just over a year now). I have had less side-effects on Humira than I had on Azathioprine, but that is just my experience.

Have you got the option to consider any of the drugs inbetween, like 6MP or azathioprine? Many people manage very well on those drugs. For me, even though I couldn't stay on the azathioprine, it was probably a good step psychologically for me to then realise that the stronger drugs are an unfortunate necessity.

Please don't carry on doing nothing though. Untreated disease will almost inevitably cause you more problems in the long run.
Click to expand...
I agree
 
Hi Atlantic,

as mentionned above, you can ask your GI about 6-mp(purinethol), Imuran or methotrexate alone as sole treatment. I have been long time in the past in remission using purinethol alone. Its a pill to take daily. These treatments existed long before Humira and Remicade and are still widely used for crohn's and colitis. Good luck.
 
Ds has been on both remicade and humira
He had far less side effects than on 6-mp or mtx as monotherapy
Remicade was easy infusion once every 6 weeks in his case
Worked great for his Crohns
But he had an allergic reaction after 8 months
Humira burns but a new version is. Owning by summer this year in the us
Ds has been on humira for 4 years
Clean scopes
Easy to travel etc..
No planning around infusions
Good luck
 
Humira was my first biologic. Yes the shots burned, for about 10 seconds during injection. It was well worth the 5 years of remission It was well worth it. The last few months I was on it, Humira lost effectiveness. As a result I was put on Entyvio. I have had 2 Entyvio infusions. With Humira I had the convenience of doing my injections at home. Now I have to take time off work and go to the infusion center. The infusion itself is about 30 minutes. I am out in 45 minutes. Entyvio's infusions are shorter than Remicade's.
 
I've been on Remicade for over 10 years now, with continued remission. I personally prefer going every 8 weeks and sitting for a couple of hours (about 3 total including time to get hooked up etc) than worrying about getting my medication in, storing it, self-injecting etc.

For me, the time getting my infusion is 'me' time - although I mostly just relax as I get benadryl as one of my pre-meds and nap a bit......it is also pretty convenient for me as the infusion clinic is at the same hospital where my GI is is, and it's only 5 minutes from work - so, I go to work early then take off for my appointment and head home after.....although I may end up going back to work after my next one due to my work schedule.....
 
Hi Atlantic, sorry you are not so well now. I know you would rather not have any treatment but It cannot be left. I understand as I too have to consider injections or infusions in the future. It is very much an individual illness : what treatment suits one may not be effective for another. I have decided on Humira injections as I eventually reacted to Remicade and had to come off, so I do not wish to go on that one again. Talk to you Consultant , ask questions then decide. I hope you feel better soon.
:rosette1::panda-wave-t::rosette1:
 
Just to add my 2 cents, I am currently on Humira and the injections don't bother me at all. It's a quick sting or burning sensation which I find only slightly annoying, the pain doesn't bother me. And I don't have any lasting pain. I do them in my belly.

But unfortunately I'm still having issues on the Humira so may be changing to another treatment shortly. Waiting to see if anything changes in the next couple of weeks.
 
Abstract

Background Maintenance anti-tumour necrosis factor-α (anti-TNFα) treatment for Crohn's disease is the standard of care for patients with an inadequate response to corticosteroids and immunomodulators.


Aim To compare the efficacy and safety of infliximab and adalimumab in clinical practice and assess the value of concomitant immunomodulator therapy.

Methods We performed an observational cohort study in consecutive patients with Crohn's disease qualifying for anti-TNFα treatment in Australia and New Zealand between 2007 and 2011. Demographic and clinical data were prospectively recorded to identify independent factors associated with induction and maintenance of response to infliximab or adalimumab, or to either anti-TNFα therapy.

Results Three hundred and twenty-seven patients (183 infliximab, 144 adalimumab) successfully applied for treatment. Eighty-nine percent responded in all groups and median maintenance of response was similar for the two agents. Concomitant immunomodulator with infliximab, but not adalimumab, demonstrated a significantly longer response overall (P = 0.002), and significantly fewer disease and treatment-related complications (P = 0.017). Corticosteroids at baseline, and/or in the preceding 12 months, were associated with a 9–13 times greater risk of disease flare during maintenance treatment as compared to no corticosteroids (P < 0.0001). Maintenance of response was similar in the anti-TNF naïve and anti-TNF experienced subgroups.

Conclusions In this large, real-life study, we demonstrate infliximab and adalimumab to have similar response characteristics. However, infliximab requires concomitant immunomodulator to achieve optimal maintenance of response comparable to adalimumab monotherapy. The results of this study will assist clinicians in further optimising patient care in their day-to-day clinical practice.
Click to expand...



Infliximab vs. Adalimumab in Crohn's Disease
RESULTS FROM 327 PATIENTS IN AN AUSTRALIAN AND NEW ZEALAND OBSERVATIONAL COHORT STUDY
J. D. Doecke; F. Hartnell; P. Bampton; S. Bell; G. Mahy; Z. Grover; P. Lewindon; L. V. Jones; K. Sewell; K. Krishnaprasad; R. Prosser; D. Marr; J. Fischer; G. R Thomas; J. V. Tehan; N. S. Ding; S. E. Cooke; K. Moss; A. Sechi; P. De Cruz; R. Grafton; S. J. Connor; I. C. Lawrance; R. B. Gearry; J. M. Andrews; G. L. Radford-Smith | Disclosures
Aliment Pharmacol Ther. 2017;45(4):542-552.






From

http://www.medscape.com/viewarticle/875197?src=wnl_edit_tpal&uac=185734DZ
 
In this study both drugs did comparably well in controlling the disease through induction and maintenance , but infliximab (Remicade) patients had a lower rate of subsequent fistula complications requiring hospitalization as compared to adalimumab (Humira) patients.

https://www.ncbi.nlm.nih.gov/pubmed/26865349

CONCLUSION:
Clinical and biochemical outcomes were similar in patients treated with IFX or ADA as induction and maintenance therapy for CD. However, significant reductions were noted in admissions relating to fistulising disease in IFX patients.
 
I made an appt. to see my GI. Can't see him for another month, but think I'm going to need to give Remicade a try. Lots of blood and pus during BMs. Humira has helped a bit; prior to Humira I had very little appetite and lost lots of weight. Now I've gained too much I think!
 
Thanks for all the great info. Certainly can be a challenge learning all these meds and med terms. Had a scan done yesterday of my Ab and pelvic areas. Had to drink formula and get an IV solution. First look at that area since 1999 when I was first diagnosed. Spoke to GI Dr just now. Said my situation has progressed. ileum had thickened. Protruding somewhat causing fistula(?) not a abscess. Really not sure what all this means but he said I must treat. He recommended again remicade. Said don't use mp6 with remi unless necessary. Stated we need to do lab work and get things set up. I told him I want to resolve this asap. He did offer that I go visit the top southeast area GI specialist in chapel hill to get second opinion but sure this will delay treatment for months. With all my questions and previously battling the realization I have an issue, he may have sensed I needed more reassurance. I am Ready to get this all going and not delay. pray it works. Oh well I am not a patient with patience. Since last posted month or so ago I have had several episodes of cramps. Went on vacation for a week skiing recently and had a fantastic time. Basically ate and drank what I wanted and had no issues. Felt great. Go figure. Soon as I get home and work stress hits me I get knocked out a day plus with cramps. Really think the mental aspect plays a huge role in my situation. I am so tried of this. Ready to find a solution. Again I am very fortunate compared to what many of you are going through. You are strong people for sure. I currently only have stomach cramping for a day or so then 2-3 days of intestinal recovery. No blood in bm or other symptoms. No other medical issues. I have lost weight in last 6 months. 208 to 187 range (but I do limit what I eat so not to cause a stomach issue). But as with conversation today with Dr, he saying my situation has gotten worse. I hope the wheels are in motion now to get this under control once I start remi treatments.
 
Of those two choices, I would try Remicade first--Just make sure you alert your infusion nurse and/or doctor right if you start to develop symptoms other than what you have previeously experienced i.e. joint pain.

I was on Remicade for a year and had great gut success with it. My body did wind up producing anti-bodies to it though (causeing joint pain/inflammation), so I did have to switch medications. However, I beleive it snatched my gut out of a really bad place and set it on the course to remission. Many people do not develop reactions to it and are able to stay on it long-term--it just depends on your body's chemical make-up and so on. The only way to know is to try it, and keep (written) track of anything new your body does.

I actually looked forward to my infusions because it was an opportunity to talk with my Remicade nurse about crohn's questions/life in general. She became part of my support team, and even though I'm off the infusions now, we still have a pretty cool realtionship. I relaize it's probably not like this everywhere, but this was my eperience.

I don't know much about Humira; I have heard the injections are painful, but if it keeps one in remission you may consider it to be worth it. Just remember, in the end the choice is yours; not your doctor's. He doesn't have to live with your symptoms.

I too, hate taking medication, so I hear ya there. Do you food journal? Food journaling has greatly helped me to isolate trigger foods and keep me honest with myself about quality of the things I put in my mouth.

I hope this has helped...Good luck!
 
Bob thanks. I really do need to hear more positive Remicade stories. Just worked up over pumping in these bios drugs that may change make up of my system in other areas but do want to find solution to cramp episodes. Did have question about why not try a moderate med first before jumping right into this remi med. Something more than my pentasa but not as radical as remi. It does sounds like many get feeling better with remi. I found a local that is on remi and she said about same thing to me. Cleared gut issue for most part but joint pain and gets a lot of skin cancer issues. That scared me because I get stress relief by going to gym working out (joints) and out on boat, being on the water in the summer in sun. Have scheduled another meet with GI this week and wife is coming to ask questions. The GI nurse is really pressing me to get on this now. I may also try to run up to research triangle NC and seek another opinion just to feel more comfortable. I don't want to procrastinate though.
 
Atlantic, I thought I would also add my two cents. I was on several drugs before Remicade. I was on Humira for about a year before I was switched to Remicade. Humira worked well, but it didn't do the trick with my fistula like Remicade has.

I'll admit, when I was first put on Remicade I found it to be very depressing. Every eight weeks seemed so daunting, like it would take over my life. I've been on it for almost seven years now, and I am happy with the results, and the infusions are just routine now--part of life, not my whole life.

But in the end, it is what works for you.

If you'd like to chat privately, don't hesitate to send me a message.
 
Remicade has allowed me to have a 'normal' life...I work full time at what can be a VERY stressful job, have a family, animals at home, travel, etc.......as I posted above, I have been on it for over 10 years (actually started October 2005, so closer to 12 years!)...at the same dosage of 5mg/kg. It has continued to work well for me.
 
Lisa said:
Remicade has allowed me to have a 'normal' life...I work full time at what can be a VERY stressful job, have a family, animals at home, travel, etc.......as I posted above, I have been on it for over 10 years (actually started October 2005, so closer to 12 years!)...at the same dosage of 5mg/kg. It has continued to work well for me.
Click to expand...

I'm really happy to hear this. My life has been much better since Remicade, and there is still a part of me that is fearful of the what iffs--what if it stops working. You have five more years on it than me, and it gives me hope. I'm glad you are doing well!
 
:ylol:
Atlantic said:
Gastro Dr told me during last visit he recommends Remicade Infusions every 8 weeks. Also said Humira injections every 2 weeks is an option. On Pentasa for last decade. Currently 8 capsules a day. Had self reduced this amount for several years because was not having many issues and do not like taking meds if can avoid. I started experiencing more episodes 6 months back and Dr increased to 8 a day. I thought have been doing fairly well with limited major episodes of severe cramping over last few months. But while not having major "sick" cramping spells, I was getting weekly more of mild stomach aches. Told Dr this last visit 3 weeks ago and he suggested Remicade or Humira. I was not happy to here this because I see all the possible side effects. Hate to create a new body problem issue by taking a med to fix something else. Also the thought of jabbing myself every other week or sitting for hours with an infusion the rest of my life is not sitting well. I do have a lot of denial of having a disease. I have told Dr I will think about what he is recommending. Really was in shock and didn't ask a lot of questions. Thinking I might prefer to bear thru the weekly gut issues as opposed to having to take injections or infusions of major drugs. Anyone have tips/advice? Is there other options that don't require all these injections? Which one of these drugs would you recommend if have to take one- Rem/Hum? Thanks so much.
Click to expand...
 
You need to determine if your symptoms are at least moderate to you. I use to you because everybody is different. If you are having what you would call bad episodes several times each week, then probably your symptoms are at least moderate. If you really desire relief from pain and/or other sxs, consider Humira first. I say Humira because if you have a bad reaction, doctors can treat it more easily than with an intravenous drip. (2 weeks of meds with Humira at a time and 1 month at a time. Humira becomes easier each time. It comes in a pen so there is not too much you can screw up. But determine first if you are moderate to severe in your symptoms.
 

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