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Should I use Entyvio for MILD Crohn's???

Hi, all. So I've been on Imuran for years for Crohn's, colon only. I was in remission, but now a series of fecal calprotectins says I have ongoing mild inflammation. Once in a while I see a bit of blood and have lots of gas, once in a while some urgency. Otherwise no diarrhea, cramping, bleeding, none of that. (I wonder if my symptoms are diet related. ) Because of the calprotectin results while on Imuran, now my doc says maybe I should consider a biologic. I asked for the one with the least awful dangers, and he says Entyvio. What if I don't do this? I am 65 and on Medicare.... and dreading another drug. Thank you!
 

my little penguin

Moderator
Staff member
Have they done scopes or imaging recently ?
Normally that is done for two reasons
One to assess the damage
Two to figure where you started from so they know if
Biologics helped

Tagging @crohnsinct

The biologic with lowest infection rate I thought was Stelara
But depends where your crohns is located
Stelara seems to do better with small intestine
And entyvio for UC like crohns (colon )

Ds has been on Stelara for over two years
Does well - he has mild crohns since age 7
Now almost 16

good luck
 
Calprotectin results without a colonoscopy is not a lot to go by to just change medication.

I don't know why your doctor suggests Entyvio to be honest, Entyvio is simply very ineffective for crohn's disease. You haven't been on Infliximab or Humira, you don't have pain, and you don't have any colonoscopy results. There's no reason why you should be on Entyvio.

You see a bit of blood once in a while. That could also be from a fistula or something else. You can't know without a colonoscopy. Entyvio is also very ineffective for fistula closure.

Patients generally only go on Entyvio or Stelara after both infliximab or humira have failed. Infliximab and Humira have much higher remissions rates than other biologics.

Stelara is more effective than Entyvio but there is really not a lot of reliable long-term data on the safety of Stelara. Blocking interleukin 23 caused cancer in several animal studies, yet this doesn't seem to happen in human subjects so far, but there are no long-term studies like you have them with infliximab.

Entyvio and Stelara are also not effective for the treatment of fistula, unlike TNF-alpha blockers. There's really no reason why you would go on those biologics unless both Infliximab and Humira have failed.
 
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If there is even a chance it’s food related is it worth doing an elimination diet for a while to see if that gets it under control? There is some suggestion that the CDED diet has helped some mild cases into remission.
They are saying entyvio is safest because it’s supposed to be gut specific rather than systemic. But all biologics have a list of scary possibilities.
On one of my admissions, a doctor told me his son with mild Crohn’s keeps it under control with daily turmeric.
It just depends how bad the disease is. If I had mild disease I could control without drugs I would (sadly I don’t). But you have to be diligent about checking it is under control because it’s a wretched and sneaky disease and uncontrolled inflammation is dangerous.
 
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