Wednesday, February 21, 2024

How Does Remicade Work For Ulcerative Colitis

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What Should You Expect From Your Home Infusion Options Nurse

How Remicade (infliximab) Works in Crohn’s Disease

Once we assign you one of our amazing infusion nurses, you will always have the same nurse. Your nurse will reach out to you and schedule your infusion, based on your preferred availability and location. Your nurse can meet you at work or come to your home, whether it be during the day, the evening or weekends. They will accommodate your schedule.

Your nurse will also answer any questions you have regarding Remicade or the Home Infusion process during the initial scheduling call.

Your nurse will get to know you and your body, they will understand your veins and the best way to access them.

Having the same nurse for every infusion makes getting your infusion a flawless experience. You and your nurse will build a strong relationship and you will always be able to consider them as a cherished advocate for your health.

Key Points About Humira

  • Humira is approved for both Crohns disease and ulcerative colitis.
  • Humira is given at home by self-injection.
  • Humira is started with 4 injections, followed by 2 injections 2 weeks later, and then 1 injection every other week.
  • Common side effects include pain or irritation at the injection site and headache, rash, and nausea.
  • If you are pregnant or plan to become pregnant, you and your doctor should decide if you should take Humira.
  • Infants born to mothers receiving Humira should not receive live vaccines for six months.
  • Humira needs to be refrigerated.

What Are The Main Differences Between Remicade Vs Humira

Remicade and Humira are both TNF blockers, also known as TNF-alpha blockers. Remicade contains the ingredient infliximab. Remicade is given as an IV infusion by a healthcare professional.

Humira contains the ingredient adalimumab. It is available as a pen injection or a prefilled syringe injection and is given subcutaneously . After proper training, Humira can be self-injected by the patient, or administered by a caregiver.

Main differences between Remicade and Humira
Remicade
Varies
Who typically uses the medication? Adults and children Adults and children

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The Time Commitment Of Infusions

In addition, the more I needed treatments, the longer they seemed to take at the hospital. At first, the sessions lasted about two hours. Then, it seemed the hospital pharmacy got slower and slower in delivering the medication to the IV therapy center.

My appointments quickly evolved to sitting in place for 3-4 hours. As a teacher, Im used to being up and moving around. Sitting still for so long created its own sort of hurt on my body.

Not to mention, the longer I sat, the more I contemplated the costs.

Protecting Intestinal Epithelial Cells From Apoptosis

Figure 1 from Mechanisms of action of infliximab in inflammatory bowel ...

Loss of epithelial barrier integrity, characterized with increased apoptosis of epithelia, is considered an early step in the pathogenesis of IBD . TNF, as the major proinflammatory mediators in IBD, is one of the extrinsic signals which initiate apoptosis of enterocytes . The action of infliximab treatment is linked with protecting intestinal epithelial cells from apoptosis. A clinical study presented that epithelial apoptoses were upregulated in the colon in Crohn’s disease and restored to normal in majority of patients by infliximab treatment , which correlated with epithelial barrier dysfunction measured as epithelial resistance.

Enterocyte apoptosis contributes to intestinal barrier dysfunction and initiation of intestinal inflammation . Suenaert and colleagues studied intestinal permeability in refractory Crohn’s disease before and after treatment with infliximab . 4 weeks infliximab infusion decreased intestinal permeability of active Crohn’s disease, measured by urinary excretion of Cr-EDTA after oral intake, confirming the essential role of TNF in modulating gut barrier in IBD.

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Key Points About Entyvio

  • Entyvio is approved for ulcerative colitis and Crohns disease.
  • Entyvio is given by infusion in three starting doses, and then every eight weeks.
  • Common side effects include infections pain in the joints, back, throat or extremities symptoms of nausea, fever, fatigue, cough, or itching and a rash.
  • If you are pregnant or plan to become pregnant, you and your doctor should decide if you should take Entyvio.
  • Its not currently known if Entyvio passes into breastmilk.

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If You Take More Than The Recommended Amount Of Remicade

Call your doctor right away if you believe youve received too much Remicade. Another option is to call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.

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Modulating Immune Cell Functions

IBD is characterized by imbalance T helper cell responses, with dominance of Th1 and Th17 responses while deficiency of Th2 and Treg responses . Downregulating the established Th1 cell responses, or shifting to Th2 and Treg responses, can successfully ameliorate IBD, as indicated by clinical and experimental research . Agnholt and Kaltoft studied in vitro the effect of infliximab on lamina propria T cell responses . Mucosal T cell cultures from patients with Crohn’s disease produced significantly higher levels of IFN- and TNF than T cell cultures from healthy controls, while the production of IFN- was downregulated by infliximab treatment in early T cell cultures from Crohn’s disease patients. Matsumura et al. have recently shown that 2 weeks infliximab infusion therapy can also modulate Th1 and Th2 balance of active ulcerative colitis and induce remission of the ulcerative colitis .

How Common Are These Side Effects

Bad Experience with Remicade (Infliximab) Infusion | My IBD Journey with Ulcerative Colitis

Common: Somewhere between 1 in every 10 people to 1 in every 100 people taking infliximab may develop this side effect.

Uncommon: Somewhere between 1 in every 100 people to 1 in every 1000 people taking infliximab may develop this side effect.

Rare: Somewhere between 1 in every 1000 people to 1 in every 10,000 people taking infliximab may develop this side effect.

This is not a full list of side effects. For more information see the Patient Information Leaflet provided with your medicine or visit medicines.org.uk/emc/.

Wed encourage you to report any side effects to the Medicines and Healthcare Products Regulatory Agency through the Yellow Card scheme. Your doctor should also report it. Report your side effect at yellowcard.mhra.gov.uk

  • Vaccinations

    Its not safe to have live vaccines while taking infliximab. It can take up to six months after your last dose for infliximab to completely leave your body. However, its safe to have live vaccines 3 months after your last dose of infliximab. Ask your IBD team to make sure your vaccinations are up to date before you start infliximab, or if youre planning to travel. If youve recently had a live vaccine you may have to wait 4 weeks before starting infliximab.

    In the UK, live vaccines include:

  • Measles, mumps and rubella
  • Flu nasal spray
  • Everyone with Crohns or Colitis taking a biologic medicine should have the yearly flu jab. This is not a live vaccine and is safe to have while taking infliximab.

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    Report A Janssen Product Quality Complaint

    You may contact the Medical Information Center by calling 1-800-JANSSEN to speak to a clinical expert regarding your question or to report a product quality complaint.

    Report a Janssen COVID-19 Vaccine Product Quality Complaint

    Report a Product Quality Complaint to Janssen at 1-800-565-4008 or 1-908-455-9922 .

    Remicade Drug Class And Form

    Remicade contains the drug infliximab, which is a biologic . Remicade belongs to a drug class called tumor necrosis factor-alpha blockers. A class of drugs is a group of medications that work in a similar way.

    Remicade comes as a vial of powder thats mixed with a liquid solution. The drug is available in one strength: 100 mg.

    A healthcare professional will give you Remicade as an infusion. This is an injection into your vein thats given over a period of time. Remicade infusions are typically about 2 hours long. Youll usually receive an infusion every few weeks, but the timing depends on the condition thats being treated.

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    Side Effects In Children

    In clinical studies, children with Crohns disease or ulcerative colitis had certain side effects more often than adults.

    Side effects that occurred more often in children were:

    • low level of white blood cells
    • bacterial and viral infections
    • allergic reactions of the throat and lungs

    Your doctor will monitor your child for these side effects during and after Remicade treatment.

    Who Are Our Experts

    Figure 1 from Biologic agents for IBD: practical insights

    Pharmacists or Nurses who are specifically trained on all aspects of the Janssen products and the therapeutic areas they treat.

    ©Janssen Scientific Affairs, LLC 2012. All rights reserved.This site is published by Janssen Scientific Affairs, LLC, which is solely responsible for its content.

    All third party trademarks used herein are trademarks of their respective owners.

    This information is intended for healthcare providers in the United States only.This page was last modified on December 12, 2022.

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    Rated For Ulcerative Colitis Report

    To anyone reading these reviews please note that everyones experience with the drug and its side effects will differ. Listen to your doctor about what is recommended for you as opposed to an anonymous review. That being said, to at least share my experience of remicade with others, I have had an overall positive experience. I have been on remicade since 2009 and it was enough to get me released from a short stint in the hospital after a severe flareup. I have experienced fatigue, increased number of colds/flus/bronchitis, as well as brain fog . I, thankfully, have not experienced worse side effects and it has overall given me a quality of life that I otherwise would not have, particularly on prednisone.

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    How Does Infliximab Work

    Crohns disease and ulcerative colitis have been linked to an increase in certain proteins – including one called tumor necrosis factor . Your bodys immune system naturally produces TNF.

    An increase in TNF is linked to an increase in inflammation in the bodys digestive system – which can lead to a worsening of inflammatory bowel disease symptoms.

    Remicade is one of a group of medications which target TNF proteins, bind to them and block them. This helps to prevent inflammation in the body which is hoped will reduce IBD symptoms. The immune system is also suppressed. This can mean that people taking Remicade are more prone to picking up illnesses and infections.

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    Differences In Administration Efficacy And Conditions Treated

    Robert Burakoff, MD, MPH, is board-certified in gastroentrology. He is the vice chair for ambulatory services for the department of medicine at Weill Cornell Medical College in New York, where he is also a professor. He was the founding editor and co-editor in chief of Inflammatory Bowel Diseases.

    Biologics are a newer class of drugs used to treat the inflammation that is caused by inflammatory bowel disease . This is a broad range of medications that each work in slightly different ways with different standards of administration and dosing. Some are approved to treat just one form of IBD, while others are used to treat both Crohns disease and ulcerative colitis.

    Because biologic drugs temper the immune response, people taking them are prone to certain infections. Its important, therefore, to take steps to reduce your vulnerability. People with IBD should receive vaccinations, ideally before starting a biologic, although many immunizations can also be given while taking a biologic.

    According to 2020 guidelines, a biologic drug should be used first-line for treatment in people with moderate to severe ulcerative colitis.

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    What Are The Worst Side Effects Of Humira

    Inside The Remicade Clinic (Infliximab Treatment)

    Humira can cause a variety of serious reactions, and some of them can be life-threatening or cause death. Humira can cause various infections, including tuberculosis. Humira may also cause lymphoma or other malignancies. Remicade can cause these serious reactions as well. Both Remicade and Humira have many other possible side effects. Before taking Remicade or Humira, talk to your healthcare provider about what side effects to expect.

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    What Are Other Possible Side Effects Of Remicade

    The most common side effects of Remicade are respiratory infections (such as bronchitis, sinus infections, cold, sore throat, coughing, nausea, stomach pain, upset stomach, back pain, diarrhea, headache, dizziness, tiredness, itchiness and urinary tract infections.

    The most common reasons that patients have stopped treatment are shortness of breath, rash and headache. As described above, sometimes these side effects can be serious and may require other treatment.

    Accent I Study Design

    ACCENT I is a 1-year, multicenter, randomized, double-blind trial of REMICADE® in 545 patients with moderately to severely active CD . All patients received an initial dose of REMICADE® 5 mg/kg IV. Patients were then randomized based on clinical response at Week 2 to 1 of 3 treatment groups through Week 541,6:

    • The placebo maintenance group received placebo infusion at Weeks 2, 6, and every 8 weeks thereafter
    • The 5 mg/kg IV maintenance group received REMICADE® 5 mg/kg IV at Weeks 2, 6, and every 8 weeks thereafter
    • The REMICADE® 10 mg/kg IV maintenance group received REMICADE® 5 mg/kg IV at Weeks 2 and 6, followed by REMICADE® 10 mg/kg IV every 8 weeks thereafter

    The coprimary endpoints of the trial were the proportion of patients responding at Week 2 who were in remission at Week 30 and time to loss of response through Week 54.1,6

    Note: The recommended dose of REMICADE® is 5 mg/kg given as an IV induction regimen at 0, 2, and 6 weeks followed by a maintenance regimen of 5 mg/kg IV every 8 weeks thereafter for the treatment of adults with moderately to severely active Crohnâs disease.1

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    What Are The Side Effects And Risks Of Remicade

    Remicade affects your immune system and can lower its ability to fight infections.

    The most common side effect of Remicade include:

    • Respiratory infections
    • Stroke within 24 hours of infusion
    • Allergic reaction during or after the infusion
    • Delayed allergic reactions
    • Lupus-like syndrome

    People taking Simponi shouldnt receive live vaccines or treatment with a weakened bacteria .

    Primary Nonresponse Vs Secondary Loss Of Response

    Remicade (Infliximab) Wholesaler

    Once a patient has been evaluated for infection and objective evidence of active IBD has been found, the clinician needs to determine whether the symptoms represent primary nonresponse to the biologic drugs mechanism of action or secondary loss of response. Primary nonresponders may react to a different class of drugs, whereas secondary loss of response may be addressed through dose escalation or the addition of an immunosuppressant.

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    How Long Do Remicades Side Effects Last Does Remicade Cause Long

    Its not known how long Remicades side effects last. But the drug may cause some long-term side effects. They may differ based on what youre taking Remicade for and other drugs you may be using.

    There have been some safety concerns regarding the use of Remicade over the long-term, including:

    If youre taking Remicade and are wondering about long-term side effects, talk with your doctor. If you have side effects that persist and dont go away, be sure to let your doctor know. Theyll work to determine the best treatment for your condition.

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    Can I Use Remicade Or Humira While Pregnant

    Check with your healthcare provider if you are pregnant or planning to become pregnant. Generally, Remicade or Humira may or may not be given in the first and second trimester, and are not given in the third trimester of pregnancy. If you are already taking Remicade or Humira and find out that you are pregnant, consult your provider right away. Babies exposed to Remicade or Humira during pregnancy should not receive live vaccines for at least six months after birth. Women who are breastfeeding should consult their healthcare provider for medical advice.

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    Dose Optimization Of Infliximab

    In addition to a dose increase, higher levels of drug may be obtained through the addition of an immunomodulator. In the SONIC trial of infliximab alone, azathioprine alone, or the combination for the treatment of CD, median trough levels of infliximab at week 30 were 1.6 mcg/mL in patients in the infliximab group and 3.5 mcg/mL for those in the combination therapy group .23 Corticosteroid-free remission rates were higher in patients with higher trough levels, although rates were still high among patients with lower trough levels. The UC-SUCCESS trial evaluated infliximab, azathioprine, or the combination for the treatment of UC and found that a higher percentage of patients on combination therapy achieved corticosteroid-free remission at week 16 compared with patients on infliximab alone or azathioprine alone .24 This study did not report whether this increase in remission rates was related to a difference in infliximab levels between the combination and infliximab groups.

    An algorithm for the evaluation and dose adjustment of infliximab in an inflammatory bowel disease patient with continued inflammation.

    ATI, antibodies to infliximab TNF, tumor necrosis factor.

    Aliment Pharmacol Ther.

    Questions About Receiving Remicade

    Infliximab (Remicade, Inflectra, Renflexis, Remsima) – IBD treatments explained by the experts

    Heres a list of questions and answers related to receiving Remicade.

    • What if I miss a dose of Remicade? Youll receive doses of Remicade from a healthcare professional. If you miss an appointment to receive your next dose of Remicade, reschedule immediately. Missing doses of Remicade may affect how well the medication works.
    • Will I need to use Remicade long term? You might. Ask your doctor how long youll need to use Remicade to treat your condition. Your doctor will assess how well the medication is working for you. Sometimes Remicade can stop working, in which case your doctor may need to switch your medication.
    • Should I receive Remicade with food? Remicade is injected directly into your vein. Receiving Remicade with or without food wont affect its absorption.
    • How long does Remicade take to work? Depending on the condition youre using Remicade for, it may take several weeks to several months before you feel the drug easing your symptoms. Talk with your doctor to find out how long it might be before the medication starts working.

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