Flaring after my third infliximab infusion :(

Sorry that you are still feeling bad. You posted about this on the 13th, I believe. If this were me, before switching to another medication, I would slow my prednisone taper down. Dropping like you have been often brings the symptoms right back. There are some great tips in your other thread about tapering.

Take care.

Hi, i flared after my 3rd infusion too, while tapering pred. I'd got down to 5mg when it happened. The hospital acted like they'd never seen that before, so it took 6 weeks to convince them it was really a flare, then they did an emergency colonoscopy the next day which confirmed severe distal inflammation. So then immediately before my 4th infusion (which was still 8 weeks after the 3rd, as planned), they measured my blood levels of infliximab and gave a double dose of infliximab (i.e. 10 mg/kg rather than 5mg/kg). My blood results showed that blood levels were therapeutic and no antibodies to infliximab, so we continued for the double dose for another infusion after that, but my symptoms did not improve enough to justify continuing so I then switched to entyvio.
I chose not to increase the pred above 5mg as I'd been on it for 18 months by that point and this was the first time I'd got below 15mg without flaring. Later I found out I had severe osteoporosis from the pred so I'm glad I didn't increase it at that stage. But it's a personal choice. I opted to take the lowest dose for the maximum level of symptoms I could tolerate.

Hi M
I think it could be wise for them to measure your blood levels of infliximab before switching
to another drug (normally they do it just before an infusion to get the trough level) to see if you have a therapeutic level or antibodies, and if a dose increase might be helpful - that is, assuming you are having a partial response to infliximab rather than zero response.

I tried entyvio for 4 months. I managed to wean off prednisone completely, but still had severe inflammation in the rectum which left me with pain and urgency, so then I switched to xeljanz. Just had my 2 year anniversary in January, it gave me my first full remission since diagnosis 4 years before, and knock on wood it's still working.