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Ulcerative Colitis
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Posted 7/13/2013 3:29 PM (GMT -5)
Does anyone know the following statistics for Remicade:

(1) What is the percentage of people that achieve remission through it?
(2) What is the percentage of people that develop cancer because of it?

Same statistics for Humira and other Bilogics?
Posted 7/13/2013 3:34 PM (GMT -5)
Remicade remission for UC:

http://www.drugs.com/news/fda-expands-remicade-indication-ulcerative-colitis-1943.html

The approval is based primarily on one-year data from the ACT 1 randomized, double-blind, multicenter, placebo-controlled clinical trial, which found that patients receiving Remicade were more than twice as likely to be in clinical remission at week 54 compared to placebo (35% vs. 17%, respectively). Furthermore, patients receiving Remicade were nearly three times as likely as patients in the placebo group to maintain clinical remission from their symptoms after one year (i.e., be in clinical remission at week 8, week 30, and week 54; 20 percent versus 7 percent, respectively). In addition, 45 percent of Remicade patients had mucosal healing at week 54 compared to 18 percent of patients in the placebo group.

(10 mg/kg)

Post Edited (Tornado6) : 7/13/2013 2:38:20 PM (GMT-6)

Posted 7/13/2013 3:47 PM (GMT -5)
I always find it fascinating that placebo groups can do so well with this disease. It would seem to me that placebo percentages should always be a lot closer to zero. UC would appear to be a real disease in which a placebo just wouldn't work so well. It's like saying that 17% to 18% of people could go into remission from mere thought alone with no meds or diet changes, etc. at all. I just don't believe that. One thing I don't like about a lot of statistics on UC treatments, such as the above, is they never seem to take into account whether or not the patient is on other meds concurrently. One person may be taking nothing other than remicade while another may be on prednisone, another on 5ASA's, another on Imuran, and yet another doing diet changes or supplements. This also applies to studies on other treatment options as well. This information could really skew the results and make them almost useless. Even though I am sure there are some kind of controls, I suspect that very few of the patients in these studies are only receiving the one treatment in the study and that is it.
Posted 7/13/2013 4:39 PM (GMT -5)
You can find the inclusion criteria for th ACT 1 and ACT 2 studies online.

www.nejm.org/doi/full/10.1056/NEJMoa050516#t=articleMethods



It is noteworthy that these studies were conducted in patients who had active disease despite treatment with conventional therapy. At baseline, among all 728 patients, 72 percent were receiving 5-aminosalicylates, 56 percent were receiving corticosteroids, and 46 percent were receiving immunosuppressants. Of the patients who were receiving corticosteroids at baseline, approximately 22 percent of patients treated with infliximab had discontinued corticosteroids by week 30 among 269 patients in both studies or by week 54 among 143 patients in ACT 1 while maintaining clinical remission. Since corticosteroid therapy is associated with considerable morbidity,29 this corticosteroid-sparing effect is likely to be clinically meaningful.
Posted 7/13/2013 4:51 PM (GMT -5)
In terms of increased risk of non-Hodgkin’s lymphoma, there is a 6 in 10,000 chance of getting cancer using Remicade. This compares to a 4 in 10,000 chance of getting cancer using only immumodulator drugs and a 2 in 10,000 chance in the general population.

So in other words, there is a slightly increased chance but the chances are still very small.
Posted 7/13/2013 5:30 PM (GMT -5)
What is the percentage chance of getting colon cancer for UC patients? Of course it would probably be different depending on how severe the UC was and for how long and how well the treatments are keeping it at bay. The doctors often trivialize the cancer odds with treatments such as Remicade which I don't really think is quite right, even though the odds are small. In the US I believe there are approximately 500,000 patients with UC so lets say that at some point 25% or 125,000 eventually use Remicade and let's say that worldwide about 500,000 UC patients eventually use Remicade. At the odds of 6 in 10,000 that would mean that 300 patients worldwide would develop cancer and that doesn't include any other patients with other diseases that would use Remicade. 300 might be a small number in the big picture but I have to say that I would not want to be one of those 300 people.
Posted 7/13/2013 9:19 PM (GMT -5)
The odd thing is that only 49-62% even respond to Remicade according to the below article. I was under the impression that it is a very effective and very quickly acting medicine. I thought that it could clear things up in a few days. I don't know if it is worth the toxicity for such a low percentage response rate.

http://www.medicalnewstoday.com/releases/108263.php
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