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Starting Remicade

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Ulcerative Colitis
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Posted 11/4/2014 6:33 PM (GMT -5)
I had a follow up visit today after my colonoscopy last Wednesday.

I'm still on 40mg prednisone, Apriso and Canasa with no changes at all.

The Dr went right to Remicade, saying that all my inflammation is "in difficult spots". I asked why the jump to biologics and he said that the other meds would take a long time to build up therapeutic levels to get me feeling better.

I pushed back and got him to rx Cortifoam and will be starting that tomorrow. He also told me to stop taking the Apriso, that it's not working. After I start Remicade we will start the prednisone taper.

Does this sound like a good plan? Is anyone on masalamine and
Remicade?

They scheduled my first loading dose for this Friday, pending insurance approval.
Posted 11/4/2014 7:05 PM (GMT -5)
Sounds right to me...my GI gave me the option to choose either Humira or Remicade for my severe crohn's colitis and proctitis and recto-vaginal fistula...I chose Humira for the convenience factor and it did put my crohn's in remission as well as healed up my fistula (though I'm getting another MRI in about 5 months to confirm the fistula is completely healed. Unfortunately I'm trying to deal with the alternating IBS issues I still have.

Your doc sounds like he's on the right track with your treatment to me.
Posted 11/4/2014 7:25 PM (GMT -5)
I'm assuming he means that to start the "other meds" he means immunosuppressives such as 6MP or imuran. Yes, they can take upwards of 3-6 months to start to work. If you are not getting any better with pred, mesalamine and rectals then he has to give you something else. If the pred was working then he could start you on immunosuppressives while you taper, but if you are not getting any better then a biologic is the next step. Not sure what his comment about "difficult spots" to treat is all about. As far as I'm concerned every affected spot of inflammation is difficult.
Posted 11/4/2014 9:06 PM (GMT -5)
RockerGirl-Yes, we talked about immunosuppressants and the length of time for them to start to work.
I did get a little aggravated when he said "difficult spot" and told him exactly what you said, "isn't it all difficult?"
How long were you on 6MP?

pb4- I hope your treatment has completely healed your fistula and you are starting to get some relief with the IBS. Thank you for the positive thoughts on my treatment plan.
Posted 11/4/2014 9:57 PM (GMT -5)
I was on the 6MP about 2-3 months. It was back in 2007 so I don't remember the exact length of time. I started it during a pred taper. I don't know in the long run what it would have done for me because I had to discontinue it due to severe body aches/joint pain/fatigue. I was very lucky to be able to just go back to my mesalamines after the pred and they kept me in remission. I don't think my side effect to the 6MP is all that common though because I don't hear too many people having that issue with it, although it is listed as a possible side effect of the drug. If your doctor tapered your pred slowly, I suppose you could give it a go prior to remicade, but it does take awhile to work. I actually think it was starting to work on me at 2-3 months and that's why I was getting side effects at that point. Prior to that I had no side effects from it.
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