Hey guys. It's been a while since I've been on the site. I had a flex scope last month and my doctor says that my j pouch is looking ulcerated. I feel fine and all of my lab work looks great. I'm taking pentasa everyday. She is concerned that my UC may have developed into Crohn's. She recommends that I start an injection treatment to see if that may prevent any further ulceration. I was on Remi in the before my j pouch and it almost killed me. It took so much out of me, chills, joint pains, etc. After doing the infusion I was in the bed for 3 or 4 days. I was wondering if anyone could give me some advice on which way to lean. Humera or Cemzia? I appreciate your time and any information.
I think you probably were experiencing allergic type reactions to the Remicade, which seems to be fairly common. Since it is a mouse based protein, you are more likely to form antibodies to it. Once you form antibodies, each subsequent infusion could induce a more severe reaction. Humira and Cimzia are fully humanized proteins, so less likely to cause antibody formation, and when they do form, the result is more likely to just be reduced efficacy, not severe allergic response.
I was on Humira for several years without incident, other than stinging during the injection. I now take Simponi, but that is not used for Crohn's, at least not yet. It is in the approval phase for UC right now.
All of the anti-TNF biologics have virtually the same safety profile, with increased risk of infection as the main issue. I've been on biologics for about 7 years, and actually have fewer infections than I used to get. Maybe that is because of the reduced inflammation in my body. I don't know. But, I have had surgery while on these drugs without incident. I can't really tell you which would be better for you, Humira or Cimzia, but Humira has been around longer, so there is more data out there. With any of these drugs, you need to be monitored regularly for liver and bone marrow function. I have blood work every three months.
The really good news is that there is a new study that compiles data on long term use of Humira. This is a huge study, covering over 23,000 patients worldwide. The big worry people cite usually is about lymphoma. But, this study showed that overall cancer rates were the same as the general population. Lymphoma rates in particular were the same as the general population, except for those with RA, which were elevated. But, the elevated rate of lymphoma in RA was within the same expected range for all RA patients, as they have a known elevated risk. But, skin cancer rates were higher in patients on Humira with RA, psoriasis, and Crohn's. The overall death rates for patients on Humira were lower or equivalent to the general population.
This is the PubMed abstract to the article:
http://www.ncbi.nlm.nih.gov/pubmed/22562972
This is the full text article:
http://ard.bmj.com/content/72/4/517.long
Jan
I was on Humira for several years without incident, other than stinging during the injection. I now take Simponi, but that is not used for Crohn's, at least not yet. It is in the approval phase for UC right now.
All of the anti-TNF biologics have virtually the same safety profile, with increased risk of infection as the main issue. I've been on biologics for about 7 years, and actually have fewer infections than I used to get. Maybe that is because of the reduced inflammation in my body. I don't know. But, I have had surgery while on these drugs without incident. I can't really tell you which would be better for you, Humira or Cimzia, but Humira has been around longer, so there is more data out there. With any of these drugs, you need to be monitored regularly for liver and bone marrow function. I have blood work every three months.
The really good news is that there is a new study that compiles data on long term use of Humira. This is a huge study, covering over 23,000 patients worldwide. The big worry people cite usually is about lymphoma. But, this study showed that overall cancer rates were the same as the general population. Lymphoma rates in particular were the same as the general population, except for those with RA, which were elevated. But, the elevated rate of lymphoma in RA was within the same expected range for all RA patients, as they have a known elevated risk. But, skin cancer rates were higher in patients on Humira with RA, psoriasis, and Crohn's. The overall death rates for patients on Humira were lower or equivalent to the general population.
This is the PubMed abstract to the article:
http://www.ncbi.nlm.nih.gov/pubmed/22562972
This is the full text article:
http://ard.bmj.com/content/72/4/517.long
Jan