Stelara every 4 weeks - how long does it take to notice the improvements?

[Crohn2357]

How long did it take for you to get into remission after your Stelara injection intervals were halved (from every 8 weeks to every 4 weeks)?

 

[my little penguin]

My kiddo took Stelara every 8 weeks for 8 months
Was miserable -scoped with inflammation
Switched to every 4 weeks and 2-3 months later was good
Fecal cal /bloodwork etc normal
Recent scope 1.5 years ago clean

 

[Crohn2357]

My kiddo took Stelara every 8 weeks for 8 months
Was miserable -scoped with inflammation
Switched to every 4 weeks and 2-3 months later was good
Fecal cal /bloodwork etc normal
Recent scope 1.5 years ago clean

Was he miserable during the whole 8 months, or did Stelara help at first but lost effectiveness and and he became ill again over that time?

 

[my little penguin]

He was miserable the whole time .
So much so the Gi wanted to just stop the med and try something else .
Rheumatologist was fighting insurance company due to his age at the time (it was only approved for those over 18 for crohns at the time )
He takes it for his juvenile arthritis and crohns.
Scope/mri at 8 months proved he was still inflamed.
So insurance approved higher frequency quickly then .
First 4 week dose he was drastically improved .
By the second one a new kid.

three years later insurance decided he needed to go to every 8 weeks again.
Gi fought it and tried one dose at every 6 weeks.
He got sick and fecal cal/bloodmarkers went up.
Insurance decided he still needed every 4 weeks and approved.
He has been on Stelara 7 years so far so good .
He does take methotrexate as well but that’s for arthritis.
He also takes a second biologic for auto inflammatory condition which does not treat crohns or arthritis.

 

[Crohn2357]

It’s infuriating how the insurance companies can play with people’s health like that. The healthcare system is fundamentally wrong. Glad to learn of his success with Stelara and other meds though. I hope it continues like that.

 

[Crohn2357]

@my little penguin @Scipio

I have inflammation and stricturing in my surgically diverted rectum. Do you think Stelara (every 4 weeks) can help with this location, based on the studies and anecdotal evidence? I’ve been on this dose for the last 3.5 months and it doesn’t seem to be helping so far, the doctor said let’s give it six months (from when I started this high dose) to reevaluate its effectiveness.

Additionally, do you think entyvio would be effective for crohns in diverted rectum (rectosigmoid stump)?

 

[Scipio]

Since I have no personal experience with inflamed post-surgical sites, I would just be guessing. So I would agree with your doc and just give the Stelara good long trial and see how it goes.

As for the Entyvio, I know that the protein that Entivio binds to is more heavily expressed in the large bowel than in the small, but what that says about the rectum I'm not sure. Extrapolating from the large bowel, it might be reasonable to theorize that Entyvio would work better on inflammation in a rectal stump than it would on some portion of the small bowel., but how that compares to what Stelara would or wouldn't do, I have no idea.

 

[my little penguin]

No surgical experience here either only mild rectal inflammation that created a rectal prolapse .
I can say most biologics (humira /stelara at least ) too a very long time to heal the rectal area for my kiddo abc he was mild.
Uceris rectal foam helped until the med could take over .
With both meds it took months
Definitely go with your Gi since it may just take a while .

 

[Crohn2357]

So I would agree with your doc and just give the Stelara good long trial and see how it goes

We are determined to give it at least full six months, thanks. Besides, if Stelara doesn’t work, the only remaining option is xeljanz and it looks neither safe nor very effective; also to use xeljanz I would have to stop using the 6MP that has been helping my crohns for years so that is something I don’t want as well.

We tried entyvio in the past, I took three doses of it and it had no effect at all at that time so we stopped using it.

 

[Crohn2357]

Skyrizi is specific for IL-23 and Stelara is specific for both IL-23 and IL-12. However, it is thought that the anti-IL-23 action of Stelara is doing the heavy lifting in battling the Crohn's inflammation. The anti-IL-12 activity appears to be just along for the ride, so to speak.

Given all that, why would Skryizi work any better than Stelara? Logic suggests that it won't, but we have the example of Remicade and Humira that both bind TNF and similarly should work just the same in treating Crohn's. But we regularly hear from patients on this forum that experienced good success with one but not the other, and vice versa.

In addition, despite their similar specificities, Skyrizi recently out performed Stelara in successfully treating IBD in a head-to-head comparison clinical trial.

With these two factors in mind , it might be worth a shot to give the Skyrizi a try. despite the earlier failure with Stelara.