-
Welcome to Crohn's Forum, a support group for people with all forms of IBD. While this community is not a substitute for doctor's advice and we cannot treat or diagnose, we find being able to communicate with others who have IBD is invaluable as we navigate our struggles and celebrate our successes. We invite you to join us.
Standard drug level for Stelara?
- Thread starter twob
- Start date
From
Induction trough levels predicted ustekinumab response in Crohn’s disease
An ustekinumab trough level of 2.0 mcg/mL or higher distinguished responders from nonresponders with an area under the receiver operating curve of 0.75.
www.mdedge.com
From
Association Between Ustekinumab Trough Concentrations and Clinical, Biomarker, and Endoscopic Outcomes in Patients With Crohn's Disease - PubMed
Ustekinumab therapy was effective in patients with CD who had not responded to or were intolerant to treatment with a TNF antagonist. Maintenance trough concentrations of ustekinumab above 4.5 μg/mL at 26 weeks or later were associated with biomarker reduction and endoscopic response.
www.ncbi.nlm.nih.gov
Keep in mind Stelara takes 6-12 months to be effective
Ds needed Stelara at 90 mg every 4 weeks but it works
Ds needed Stelara at 90 mg every 4 weeks but it works
Well 4 weeks after the injection the level was 3.9……
….the Dr ordered the test since my Calprotectin level went from the 200’s before Stelara to mid 300’s now….
The good thing is that I don’t have antibodies to it.
Probably I am not a super responder….but I wish this thing will work…..Remicade calprotectin went less than 50 but I was all the time with colds….so far with Stelara no colds…..let’s see maybe if he increases the dose?
….the Dr ordered the test since my Calprotectin level went from the 200’s before Stelara to mid 300’s now….The good thing is that I don’t have antibodies to it.
Probably I am not a super responder….but I wish this thing will work…..Remicade calprotectin went less than 50 but I was all the time with colds….so far with Stelara no colds…..let’s see maybe if he increases the dose?
Lynda Lynda
Member
Been on Stelara since October 2021.
90mg every 8 weeks.
Going to have my levels checked again next week to see if I may have to inject every 6 weeks or 4 weeks.
90mg every 8 weeks.
Going to have my levels checked again next week to see if I may have to inject every 6 weeks or 4 weeks.
Hey hopefully if you need it your insurance will cover it.!!!
My insurance refused to cover it every 4 weeks.
I still don't know how this will end.
I could try to change to another insurance company.
I wonder if there is a way of knowing if an insurance company will cover it every 4 weeks. Is that FDA approved?
My insurance refused to cover it every 4 weeks.
I still don't know how this will end.
I could try to change to another insurance company.
I wonder if there is a way of knowing if an insurance company will cover it every 4 weeks. Is that FDA approved?
What was your level after the initial IV infusion?Well 4 weeks after the injection the level was 3.9……
The good thing is that I don’t have antibodies to it.
Probably I am not a super responder….but I wish this thing will work…..Remicade calprotectin went less than 50 but I was all the time with colds….so far with Stelara no colds…..let’s see maybe if he increases the dose?
Lynda Lynda
Member
For the first year ( 2022 ) the Johnson & Johnson Patient Assistance Foundation was funding my Stelara. I collect SSD and have Medicare / UHC health insurance and live in the USA. Starting in 2023 the JJPAF was only assisting people with no health insurance, this is when Janssen took over with funding my Stelara. I don't take this assistance for granted, I am truly blessed that I was approved to get financial help.
Lynda Lynda
Member
I do not remember.
I go to Sonora Quest Laboratory for the Stelara blood draw, but it is a "pass through" test and is sent to Prometheus for processing. This means that my test results for this blood draw is not located on the Sonora Quest Lab patient portal for me to look at, but the report is sent to my Gastroenterologist office. I can get copies of all my Stelara blood draw results from my Gastroenterologist office so I can look at them.
[ My infusion was in October 2021. ]
No, not FDA-approved. I believe the FDA has approved only the standard 8-week dosing for Stelara, although many docs use it "off label" at 6 or 4 weeks.
Last edited:
Definitely not fda approved at 4 weeks
But my kiddo has been on that dose for almost 6 years
Insurance is hit or miss on what they approve
But my kiddo has been on that dose for almost 6 years
Insurance is hit or miss on what they approve
Lynda Lynda
Member
Is this a good or bad Stelara level? This is dated Dec 2022. Recently had it taken again in April 2023 but have not been informed of the 2023 results. My infusion was 2021 October. Injection every 8 weeks.
Attachments
I think it's an absolute bad if the level is undetectable or you have developed resistance to it. How are you feeling otherwise?
My son is up for his injection this week so I have you on my mind. I hope you are doing well.
The exact cut-off for Stelara has not been established, but 4.5 is generally regarded as a solid number. And the further good news is you don't have antibodies against the drug.
So with sufficient drug on board (or at least it was last December) and no antibodies, the drug should be controlling your disease. If it is not you may need to think about switching to something more effective. Your more recent drug level test should be informative.
So with sufficient drug on board (or at least it was last December) and no antibodies, the drug should be controlling your disease. If it is not you may need to think about switching to something more effective. Your more recent drug level test should be informative.
They did not checked it
They will deliver the pen tomorrow, Actually they approved it every 4 weeks for a year…..26 k per injection…..12 injections around 300.000.
It should not bother me I know but something is not right….
Was the Stelara blood level test before the injection or after the injection?
Lynda Lynda
Member
Stelara level blood draw done 1-2 days before Stelara injection
Lynda Lynda
Member
My GI is going to increase Stelara to every 6 weeks if approved by Janssen ( I am getting it free through Janssen.) NP at GI office took me off my 3mg daily Budesonide in March, was sick for over a month, went to Hospital, started on Prednisone to be tapered down and back to 9mg Budesonide a day. It's obvious that just the Stelara alone is not keeping my Crohn's under control. So after tapering the Prednisone back to Budesonide my Crohn's meds will be exactly the same as they were 2 years ago ( except Stelara every 6 weeks instead of 8 weeks.) Of course with my current dose of Prednisone ( today 30mg ) I have a great appetite and no diarrhea so I'm not panicked. Thanks for all your help. Will hopefully get my updated Stelara levels soon.
Please call Mayo Clinic
If you start the conversation woth then now
When things are where your ready to go
It will be a few months later 5-6 months
Then if you are good you can cancel
We did that for my kiddo so much better than calling when you need it and being told to wait 5-6 months
If you start the conversation woth then now
When things are where your ready to go
It will be a few months later 5-6 months
Then if you are good you can cancel
We did that for my kiddo so much better than calling when you need it and being told to wait 5-6 months
I was reading the second and third message in this thread and it seems that 4.5 is a good Stelara level
Lynda Lynda
Member
I clicked on the link provided here and sent a request to Mayo for information. Got a call from the Central Appointment Office and he confirmed that they don't accept my Health Insurance. He gave me their Tax ID # for future use. I would not be able to change Health Insurance plans until enrollment period this Autumn 2023. Anyhow, that is all I have done so far. I need my follow up appointment with my GI or NP at my GI's office so that they can answer a few questions for me. Going to call Prometheus back tomorrow so that they can e-mail me or send a paper copy of my recent Stelara level testing. I cannot access these results online at Sonora Labs due to it being a "pass through" test." Honestly, the less I have to communicate right now by phone or patient portal to my GI office is best for me. My GI office is working on my Stelara every 6 weeks instead of 8 weeks, I would like to have that done / approved by my financial support at Janssen so I can do my next injection on June 2nd which is 6 weeks from my April injection. The wheels turn slowly at my GI's office. Of course my bowels are behaving right now because of the Prednisone, so my mood is light. I will enjoy this time while I have it. Ate chocolate candy todayPlease call Mayo Clinic
If you start the conversation woth then now
When things are where your ready to go
It will be a few months later 5-6 months
Then if you are good you can cancel
We did that for my kiddo so much better than calling when you need it and being told to wait 5-6 months
. Thanks to everyone for their help.
Lynda Lynda
Member
I haven't read this yet, as I only have phone screen print and not computer sized print. But my simple math skills (From
Association Between Ustekinumab Trough Concentrations and Clinical, Biomarker, and Endoscopic Outcomes in Patients With Crohn's Disease - PubMed
Ustekinumab therapy was effective in patients with CD who had not responded to or were intolerant to treatment with a TNF antagonist. Maintenance trough concentrations of ustekinumab above 4.5 μg/mL at 26 weeks or later were associated with biomarker reduction and endoscopic response.
) say 26 weeks on Stelara every 8 weeks is 182 days. I have used Stelara every 8 weeks for 288 days ( or 18 months. )
Lynda Lynda
Member
Well this sucks. I am now at the hospital emergency room for severe abdominal pain and they did another CAT scan. They gave me morphine but that does not help the pain in the my abdomen, it just makes my head feel wonky. I tried all morning to poop and I couldn't, I pushed so hard that my hemorrhoids are swollen up and bleeding and I pushed so hard that I just kept throwing up everything in my stomach. My theory is this, my poop is hard and will not come out of my body and that is why I am terrible pain and my sigmoid colon area down to the rectal area. I really want them to give me an enema to get that poop out of my body. When I was in the hospital 2 weeks ago I was there because of diarrhea. Now I'm on the prednisone still and my take on this abdominal pain is that now I'm probably constipated because of all the steroids, but I'm not a doctor so I don't know what the heck is going on. My landlord must think I'm crazy because I've been to the hospital twice this month and I've only lived at her house for less than 4 months. My landlord is a very nice person and a Christian lady and so she genuinely cares about her tenants , but I do not want to be an inconvenience to her so I hope she understands that I am doing my best to feel better. I have been moving around a lot the last 3 years and I'm 62 years old and tired so I want to stay at my current address for as long as possible because really it is a good place to live. I normally just sit around in my recliner all day and relax and nothing significant usually happens, but this month is an exception. I wish doctors could figure this stuff out. So I am either having diarrhea and end up in the hospital or having abdominal pain probably from constipation. I hate it in the hospital emergency room where they immediately save blockage and surgery and they don't even know who I am. They gave me morphine so I'm a bit chatty, more chatty than usual. My gastroenterologist does not have privileges at the hospital I am at right now, but I don't care because he just wants to get rid of me and send me Mayo Clinic. My sister has money and so maybe I can go to the Mayo Clinic for one appointment to be evaluated and she would pay for that one appointment because all she wants for me is for me to be happy. Mayo is a 40 mile round trip from my current residence. Maybe I'll lose some weight with this Crohn's craziness, I weigh 200 lb and have a fatty liver and bad bones so weight loss would be a blessing. Later.
Sending lots of hugs your way
The prednisone shouldn’t have constipated you
But any pains meds may have
Hope they figure it out soon
The prednisone shouldn’t have constipated you
But any pains meds may have
Hope they figure it out soon
Lynda Lynda
Member
I had called an ambulance and the ambulance had to take me to the closest hospital which is not the hospital where my GI has privileges so it was a waste of time last night and early this morning going to that hospital only to go home feeling the same way as when I left. So believe it or not this morning I packed up a tote bag with Hospital stuff in it and my purse and I called a cab and took the cab to the hospital that is farther from my house but the hospital that my GI has privileges. So I've been getting all sorts of testing done and evaluation and IV medication and stuff like that and now they're going to put me upstairs for observation. My current symptoms are abdominal pain and cramping and my rectum is either inflamed or enlarged or something like that. So these are totally different symptoms that I had from the beginning of May. Yesterday morning I had sat in the bathroom for at least 2 hours pushing and pushing to have a bowel movement and nothing happened nothing happened except I vomited up everything in my stomach because I was pushing so hard to have a BM in the BM never happened . So of course now my rectum hurts. This morning I laid down in this hospital bed to take all the pressure off of my rectum then I no longer had the abdominal pain and cramping. Not quite what sure they're going to do during observation or what kind of medicine they're going to give me but one of the nurses came into my room down here in the ER to get my detailed prednisone tapering schedule so we can get all that started up again today. Now that I know that the fire department in the city I live in is very diligent about not taking me to the hospital I want to then I will just start calling a cab and go to the hospital that I'm supposed to which is farther away from where I live. Last night was a waste of time at that other ER Hospital place because they just sent me home like I was cured or something.
Glad your being seen now
Hope they get to the bottom of it
Hope they get to the bottom of it
Lynda Lynda
Member
I will have CVS order the hydrocortisone suppositories and proctofoam, I called 3 CVS locations and it's not in stock. Of course ER Doctors give me a paper prescription and it doesn't get sent electronically. Only had liquids for two days now. Will try soft food tomorrow 
.... but may need the foam and suppositories before I eat that ?
My arse is almost swollen shut.
Cream of Wheat and also applesauce should be ok.
I did pass one very small good looking poop today.
That expensive OTC tube of Preparation H with lidocaine is worthless. Heating pad for my tummy and sitz bath for my arse arriving soon from Amazon, and adult diapers and adult diaper plastic bags.
Mostly bloating since nothing's in my stomach.
Took the waffle foam pillow thing from the Hospital, it's comfy.
.... but may need the foam and suppositories before I eat that ? My arse is almost swollen shut.
Cream of Wheat and also applesauce should be ok.
I did pass one very small good looking poop today.
That expensive OTC tube of Preparation H with lidocaine is worthless. Heating pad for my tummy and sitz bath for my arse arriving soon from Amazon, and adult diapers and adult diaper plastic bags.
Mostly bloating since nothing's in my stomach.
Took the waffle foam pillow thing from the Hospital, it's comfy.
Lynda Lynda
Member
For two months the MA at my GI's office has been bumbling with the simple paperwork to get my Stelara from Janssen every 6 weeks. I have been doing my injections every 8 weeks, since my initial infusion, in October 2021. The MA, at the time, in 2018, could not even figure out how to do all of her part of my Humira paperwork. The current MA at my GI's office does not know what she is doing. I have called Janssen 4 times and the MA 3 times. Today I calledvJannssen just to double check on what was going on because my next injection ( now every 42 days ) is August 1st. Janssen said they have all the paperwork now from my MA at my GI's office EXCEPT the part on the form for the number of days between each injection was left BLANK. So that has to be done by my MA soon and today Janssen said they would call the MA at mynGI's office, after the MA returns from lunch, to tell her what to do. This is the most ridiculous situation ever. The MA is taking 2 months to not even get the simple paperwork done when the paperwork could be done in 10 minutes. Right now I cannot manage my Crohn's symptoms without the Budisonide, so that is why my GI is increasing my Stelara to every 6 weeks. When I do start every 6 weeks how long after that would I get my first blood test to check my Stelara levels ? My GI tried to discontinue my one 3mg Budesonide a day at the end of March and I was sick for 6 weeks until Prednisone was prescribed then after Prednisone taper the Budesonide was reintroduced at the full dose of 9mg a day. My Endocrinologist knows abput my Budesonide. I am seeing a surgeon in August to talk about thyroid removal and my Endocrinologist has written a note to inform the surgeon and anesthesiologist about my possibility of secondary adrenal Insuffuciency. I believe the instructions from my Endocrinologist talks about solumedrol before the surgery. I have the letter in my purse.
Lynda Lynda
Member
My Otolaryngoloist is going to schedule my
thyroidectomy for October 2023.
My Stelara injections are going to be every 6 weeks instead of 8 weeks starting September 26, 2023.
thyroidectomy for October 2023.
My Stelara injections are going to be every 6 weeks instead of 8 weeks starting September 26, 2023.
Lynda Lynda
Member
I know that this has nothing to do with this thread or Crohn's disease but I am having my thyroidectomy next Tuesday. My endocrinologist has been monitoring my thyroid nodules for quite a while now and has even done biopsies and the biopsies come back inconclusive. So my endocrinologist finally recommended that I have my thyroid removed. I will be in the hospital overnight and will go home the next day. Due to the possibility of secondary adrenal insufficiency, my endocrinologist has requested that my anesthesiologist give me IV hydrocortisone or Solumedrol 30 minutes before surgery. Thank you for listening.
Good luck on the surgery
Glad your getting iv solumedrol before
It really helps my kiddo before scopes
Glad your getting iv solumedrol before
It really helps my kiddo before scopes