Trying a 3rd biologic?

[Polaris]

I have a decision to make.

Remicade and Humira have now both failed me and my GI is trying to get me on board with Cimzia. But because I've already failed 2 biologics I feel like it would be a waste of time, and would like to try Entyvio (which she said she's willing to prescribe instead).

Has anyone failed 2 biologics and had any success with a third? Should I move on to a different, but still really new, treatment? I don't know what to do.

 

[DJW]

Entyvio is quite different from remicade and humira in how it works...I think. Maybe some hope there.

 

[KayleighMeek]

I have tried humira and remicade had reactions to both and I am now on cimzia. I am doing well on it and have been for over a year now. It did take a while for it to start working and I would like to try weekly, like I did with humira, but the Drs won't let me because of the lack of data which I understand. It's not been a waste of time for me but I only had the choice of cimzia, trials or surgery in the uk so thought I would give this a try first.

 

[alex_chris]

Very sorry to hear you failed 6mp, and now also both humira and remicade.

Can I ask why you failed them? Was it due to side effects or did you use both biologics for a longer time without side effects, but your Crohn's remains heavily active?

The reason why I am asking is just simply statistics. Cimzia (as another TNF-alpha blocker) has a higher success rate than Entyvio. If you look at the success of Entyvio for people who tried biologics before it is higher than placebo, but not by that much: "15% (32 out of 220) of patients receiving vedolizumab showed improved symptoms after 6 weeks of treatment, compared with 7% (10 out of 148) of patients on placebo. The maintenance of the effect up to 52 weeks was more effective with vedolizumab than with placebo."

Or in other words, I would talk to your doc again whether it makes sense to a. go for Cimzia instead of Entyvio if you failed humira/remicade not because of some fundamental problem with TNF-alpha blockers, but just because you did not get any relief in symptoms from them, but b. go for Entyvio over Cimzia if you failed humira/remicade because of problems with TNF-alpha blockers in general (side effects that required you to stop treatment).

 

[R20]

My humira treatment failed. Worked initially but then saw no improvement and inflammation continued to get worse. I then had a 1 week hydrocortisone treatment which worked incredibly well. Crp went from 180 down to 16!!! Following the steroid treatment we have used remicade to maintain the remission. I'd say anything is worth a go.

 

[Polaris]

Very sorry to hear you failed 6mp, and now also both humira and remicade.

Can I ask why you failed them? Was it due to side effects or did you use both biologics for a longer time without side effects, but your Crohn's remains heavily active?

The reason why I am asking is just simply statistics. Cimzia (as another TNF-alpha blocker) has a higher success rate than Entyvio. If you look at the success of Entyvio for people who tried biologics before it is higher than placebo, but not by that much: "15% (32 out of 220) of patients receiving vedolizumab showed improved symptoms after 6 weeks of treatment, compared with 7% (10 out of 148) of patients on placebo. The maintenance of the effect up to 52 weeks was more effective with vedolizumab than with placebo."

Or in other words, I would talk to your doc again whether it makes sense to a. go for Cimzia instead of Entyvio if you failed humira/remicade not because of some fundamental problem with TNF-alpha blockers, but just because you did not get any relief in symptoms from them, but b. go for Entyvio over Cimzia if you failed humira/remicade because of problems with TNF-alpha blockers in general (side effects that required you to stop treatment).

Thank you for this, gives me a lot to consider. With both Remicade and Humira I built up antibodies fairly quickly. Remicade after only 4 infusions, Humira after about 9 months. I knew they had stopped working because my symptoms returned like a brick wall and inflammation was still very much present (as seen on colonoscopies). I have the Cimzia ordered already and I'm leaning towards giving it a chance and leaving Entyvio for the future if needed.

 

[Robrich]

Being as you failed due to antibodies cimzia is worth a go.
you might want to try a combo therapy. If 6 mp failed you could try MTX that's what I am doing now with Entyvio and it seems to be helping but ENTYVIO is slow.
Good luck

 

[alex_chris]

Stelar, I hope things work out for you. Yes, Cimzia as the next med to try seems best. As Robrich has suggested, also look into combination therapy together with MTX or alternatively aza (in lieu of 6mp). I am sure if you think positively about all that, you find the right mix and get things under control.

 

[Polaris]

Well I had my first dose of Cimzia today. Let's hope it works!

 

[KayleighMeek]

Good luck! Keeping my fingers crossed for you this works