Stopping and restarting Humira

[Alpo]

Hey all,

I've gone about 2 years meds-free by controlling my diet and eating what I found to be "safe".

Things have spiraled out of control in the past few months and it looks like I might try getting back on Humira, since it was the most successful treatment I've undergone in the past.

Does anyone know the likelihood of your system rejecting it after stopping for this length of time?

I know I missed a remicade infusion and my system rejected it after basically stopping for a month.

Thanks in advance,

Alex

 

[Walt]

antibodies to biologics...

Hi Alex,
Sorry I can't be much help. I suspect you already know:
No one can really say to what extent your system may have formed antibodies to the biologics.
Nor to what extent those antibodies might render the biologic less effective, or even ineffective.

I am unaware of any test which might measure this?
Perhaps someone will chime in about that?

Maybe this will offer you some encouragement:
A Crohnie friend of mine had to stop Remicade due to an insurance change.(lost it)
When the money dried up, so did her crucial infusions.
(sorry, I hate reminders that our treatments are big dollar business)
It took several months to arrange new financing and get her back on Remi.

She was able to resume the biologic infusions and has been doing ok.
There was concern that Remi would not work as well, but it's been ok, so far...
knock on wood!

everyone is different,
good luck to you
Walt

ps I wonder if:
once a biologic does not help someone, does that mean it will never help them again?
Is there any chance, after it fails for an individual, that it might work later on?
hmm...

 

[katiesue1506]

Hi there. I was on Humira for about 8 months once and stopped it. I then went back on it about 2.5 years later. I've been fine with no rejection. This was after I, too, rejected Remicade for the second time.

Chances of rejection for Humira are lower versus Remicade because of the human protein being used over the chimeric (mouse) protein in Remicade.

The only thing I've noticed is that I've had to go to one Humira shot a week. I've been pretty decent healthwise for about a year and couple months now. Every now and a again I have my days... but I'm mostly formed and not in too much pain.

Good luck!

 

[Walt]

another view on the ole 'mousetrap'...

Chances of rejection for Humira are lower versus Remicade because of the human protein being
used over the chimeric (mouse) protein in Remicade.

Hi KatieSue,
Thanks for jumping in.
I'm glad to hear that you've being doing alright!

Sorry to sound contrary, but allow me to play devil's advocate for the sake of a well-rounded discussion.

There is a terrific new book by Dr. Sunanda Kane, released in 2010,
entitled IBD Self-management: The AGA guide to CD and UC.
(American Gastroenterological Association)
She is a world renowned IBD authority and does research at the Mayo clinic.
Strong and helpful book, in plain language by the way. One of my favs.

Re: Remicade being 75% human and 25% mouse proteins, vs 100% human for Humira and Cimzia.

She suggests that this common belief is antiquated by current thinking.
On page 73. she says:
"We used to think that it mattered how much of a biologic is nonhuman,
but it turns out that, because all of these proteins are foreign to you,
your body has just as much chance of reacting to a medication that is part mouse as one that is all human."

"I'm not convinced that any of the biologics are better than the others."

me again...
So the way I see it, since all of the biologics are antibodies, and foreign to us,
your body can form an antibody to the antibody.
This can lead to either a 'hypersensitive' allergic reaction, or a loss of beneficial response. (less effective or ineffective)

Just wanted to offer another side of the popular 'mouse' issue.
Crohn's is a very individual disease.
It varies from person to person, and it varies within the same person over time. (tricky b*tch)
And so, YMMV (your mileage may vary)

Hope you feel well,
sincerely,
Walt

ps I'm new to these drugs and would be glad to hear the thoughts and
experience of others on biologics
thanks

 

[My Butt Hurts]

I've not heard of one instance in which anyone had an allergic reaction to restarting Humira. (Not saying that it hasn't happened, just saying that I have never heard of it.)
I have heard of MANY reactions to Remicade when starting it after stopping for a while.
I do know that there is a test to see if you have built up antibodies to Remicade.
I wouldn't think that there would be a problem restarting Humira, but I guess you should ask your doc to be sure.

Welcome to the forum, Alpo!

MBH

 

[CDDad]

I've stopped and started Humira many times. A few times for surgery so maybe it's not working for me (duh).

My doc always restarts it and has again now that I am symptom free after my last big surgery.

 

[countrycoffeehouse]

same here. Reacted badly to remicade missed treatment. But Humira has been stopped and restarted.. I did have to go 1/week to take the disease back to mild flare. I did the start up pack of Cimzia and then lost insurance. You should be fine