Sunday, December 4, 2022

Remicade Infusion For Ulcerative Colitis

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Can I Get Vaccines While Being Treated With Remicade

Infliximab for Patients with Severe Ulcerative Colitis – IBD in the News

Yes and no. You can get inactive vaccines while taking Remicade. Inactive vaccines are made from germs that have been killed. Many of the vaccines that doctors recommend are inactive.

However, Remicade can weaken your immune systems ability to fight infections.* So you shouldnt get live vaccines during treatment. Live vaccines are made from weakened forms of germs. Examples of live vaccines to avoid while taking Remicade include the measles, mumps, and rubella vaccine and the yellow fever vaccine. For more information, see the Remicade interactions section above.

Before you start taking Remicade, check with your doctor to see if youre up to date on your vaccines.

This drug comes with several precautions.

Key Points About Simponi

  • Simponi is approved to treat ulcerative colitis.
  • Simponi is given by injection at home.
  • Simponi is started with two injections, followed by one injection two weeks later, and one injection every four weeks thereafter.
  • Common side effects include pain or irritation at the injection site and upper respiratory or viral infections.
  • If you are pregnant or plan to become pregnant, you and your doctor should decide if you should take Simponi.
  • It’s not currently known how Simponi will affect a nursing infant.
  • Simponi must be refrigerated.

Side Effects Of Ulcerative Colitis

Side effects are based on the biologic medication that youre receiving. While some are minor, others may be life-threatening. You should talk to your doctor before receiving infusion therapy to ensure that you are getting the best option for your UC. The most common side effects include:

  • Serious allergic reactions
  • Lymphoma and other cancers including skin and cervical cancer
  • Heart problems including failure
  • Psoriasis

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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

Side Effects And Risks

Sometimes We Become Numb

Remicade and Humira work in different ways but have some similar side effects. Examples of common and serious side effects for each drug are listed below.

People in both Remicade clinical studies and Humira clinical studies had side effects. But these may be symptoms of other side effects. For example, a fever may be a symptom of an infection. Side effects may overlap between the drugs.

More common side effects

Here are examples of more common side effects that can occur with Remicade, with Humira, or with both drugs .

  • Can occur with Remicade:
  • psoriatic arthritis
  • plaque psoriasis

These drugs havent been directly compared in clinical studies, but studies have found both Remicade and Humira to be effective for treating the conditions mentioned above.

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Key Points About Stelara

  • Stelara is approved to treat Crohn’s disease.
  • The loading dose of Stelara is given by infusion and thereafter is given by injections at home.
  • People taking shots for allergies should talk to their doctor about possible allergic reactions and Stelara.
  • Common side effects include infections, injection site reactions, and vomiting.
  • If you are pregnant or plan to become pregnant, you and your doctor should decide if you should take Stelara.
  • It’s thought that Stelara does pass into breastmilk.
  • Stelara must be refrigerated.

What Can Remicade Do For You

So your GI doctor says to you, I think we should use Remicade to treat your IBD. We can set you up to do convenient in-office infusions. Your brain suddenly goes into overdrive. You have so many questions! What is Remicade? How is it given? What is an in-office infusion? What are the side effects? Dont fret. Read on and you will find the answers to all of these questions, and more.

Remicade is an immunosuppressive prescription drug used to treat autoimmune diseases, such as Crohns Disease, Ulcerative Colitis, Rheumatoid Arthritis, Psoriatic Arthritis and Anklylosing Spondylitis. This autoimmune response is caused by too much of a protein called tumor necrosis factor-alpha circulating in the body. High levels of this protein cause the bodys immune system to mistakenly attack and destroy cells in the body.

In the case of Ulcerative Colitis , the attack occurs in the large intestines. In Crohns disease, the gastrointestinal tract from the mouth to the anus is assaulted causing inflammation. This can lead to symptoms of diarrhea, abdominal pain and GI bleeding. Remicade blocks the TNF-alpha protein produced by the immune system. This reduces inflammation and puts the Crohns and UC into remission. Remicade has been used to treat over 1 million patients with autoimmune diseases and has been studied for over 17 years.

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Drug Forms And Administration

Remicade comes as a vial of powder. Your healthcare provider will mix it with a liquid to make a solution. They will then give you the Remicade solution as an infusion. This is an injection into your vein thats given over a period of time.

Youll go to your doctors office or a clinic to have the infusions. Remicade infusions are typically around 2 hours long. The usual dosing schedule is once every 8 weeks after you complete the first stage of dosing.

Humira comes in three forms:

  • a prefilled, single-dose syringe
  • a prefilled, single-dose pen
  • a single-dose vial for use only by a healthcare provider

Humira is given as an injection just under your skin . A healthcare provider can give you the injections, or you can inject yourself at home. The usual dosing schedule is one injection every other week.

What Is The Most Important Information I Should Know About Remicade

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

Talk to your doctor about your medical history to determine whether you need additional monitoring during treatment. There are certain medical conditions that may make it dangerous to undergo treatment with REMICADE®, including:

  • Tuberculosis
  • Infections that keep coming back
  • Cancer
  • Hepatitis B
  • Nervous system disorders

In addition, some medications may not react well when combined with REMICADE®. Tell your doctor about all drugs youre currently taking, regardless of whether theyre prescription, over-the-counter, vitamins, or herbal supplements. Specific medications that may require additional attention include Kineret , ORENCIA® , or ACTEMRA® , as well as biologics. Patients who are undergoing treatment with REMICADE® should not receive live vaccines. Tell your doctor if you have any vaccines scheduled.

REMICADE® could also increase the risk of blood infections, lymphoma, skin, or cervical cancer. Tell your doctor if you see any changes or growths on your skin, or are experiencing poor appetite, flu-like symptoms, or painful or opens sores.

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Tips For Good Reviews

  • Only rate drugs or treatments you’ve tried.
  • In your description, mention the brand, dose, and period of time that you used the drug or treatment.
  • Please share your positive and negative experiences with the drug, and compare it with other treatments you have used.
  • Do not include any personal information or links in your review.

Crohns Disease And Ulcerative Colitis Infusion Treatment

When living with Crohns disease or ulcerative colitis, one of the first things you may want to know is how the disease is treated. Treatment often consists of one or more prescription medications, which help to suppress the immune response that is causing inflammation to the gastrointestinal tract. In addition to biologic agents, people with Crohns disease and ulcerative colitis often have low levels of iron in the blood, and therefore may benefit from intravenous iron infusions.

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Monitoring Of Vital Signs

As a foreign protein-derived agent administered intravenously over a 2 h infusion period, infliximab can cause infusion reactions. Formation of antibodies to infliximab may increase the risk of infusion reactions . These infusion reactions can be categorized as acute or delayed. An acute infusion reaction is defined as any adverse event occurring during infusion or within a period of 24 h after infusion . Severity can vary from mild to severe life threatening, and symptoms may include nausea, flushing, dizziness, dyspnoea, chest pain and hypotension or hypertension. Delayed infusion reactions are defined as reactions occurring from 24 h to 14 days after treatment with infliximab and symptoms may include arthralgia, rash, myalgia and fatigue .

In randomized controlled trials with infliximab, vital signs were monitored vigorously. Monitoring body temperature at baseline is performed to rule out fever possibly based on infection and monitoring during infusion is performed while concerns exist about developing fever during an acute infusion reaction. The monitoring of blood pressure and pulse is based on the concern that during infusion with infliximab an anaphylactic shock could develop with typical hypotension.

Could Remicade Stop Working For Me

Tips for Your First Remicade Infusion

Yes. Remicade may become less effective for you over time. This can occur if your bodys immune system starts to recognize Remicade as a foreign invader and makes antibodies to Remicade. Antibodies are immune system proteins that fight foreign substances, including medications such as Remicade.

If your body makes anti-Remicade antibodies, the drug will clear from your system faster and wont be as effective.

Remicade may also stop working for a time because of stress, dietary choices, or other health conditions.

If youre concerned about how effective Remicade is in treating your condition, talk with your doctor.

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Is Remicade A Form Of Chemotherapy

No, Remicade isnt a form of chemotherapy. Remicade is a biologic, which means its made from living organisms. Specifically, Remicade is monoclonal antibody thats made from immune system cells in a lab. Monoclonal antibodies only block the activity of certain proteins in the body.

Chemotherapy, on the other hand, is a chemical drug that destroys rapidly growing cells throughout the body. Its typically used to treat cancer. Chemotherapy medications affect many types of cells and organs. This is different from the very specific actions of monoclonal antibodies, such as Remicade.

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 Crohn’s disease and ulcerative colitis.

Because biologic drugs temper the immune response, people taking them are prone to certain infections. It’s 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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But It Also Hurt My Wallet

As I received another treatment, I got hit with another $500 bill. Yes, my health insurance covered 80% of the costs, so I was thankful for that much. But in reality, I couldnt afford $500 for every infusion.

The IV regimen follows at 0, 2, and 6 weeks. Then, a maintenance regimen of every 8 weeks afterward. In short, the bills began to pile up. That added to my anxiety, which my UC didnt need.

Key Points About Humira

Ulcerative colitis / remicade infusion day
  • Humira is approved for both Crohn’s 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.

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Rated For Ulcerative Colitis Report

To anyone reading these “reviews” please note that everyone’s 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.

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 provider 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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Preparing For A Remicade Infusion

You will need to talk with your doctor or gastroenterologist to see if Remicade is right for you. Make sure you tell your doctor about your familys medical history as well as any medications you are taking. Tell your doctor if you suffer from:

  • Tuberculosis
  • Allergic reactions to ingredients in Remicade
  • Nervous system disorders including seizures, multiple sclerosis

Before a Remicade infusion, it is recommended that you get a good nights sleep, consume ample fluids and eat breakfast or lunch before your treatment. A nurse will perform general assessment tests of your health and record your blood pressure, temperature, respiration, pulse and weight.

Combination Therapy With Methotrexate And Other Drugs

Remicade Day

Your doctor may prescribe medication for you to take with Remicade to better control your symptoms. These drugs often ease inflammation by treating different parts of your immune system than Remicade does.

For example, the American College of Gastroenterology recommends combination therapy for people with moderate to severe Crohns disease. The guidelines suggest using Remicade with medications such as azathioprine or methotrexate . They also recommend taking corticosteroids, such as prednisone, with Remicade or other similar drugs.

Examples of other medications that may be used with Remicade to treat symptoms of rheumatoid arthritis include:

Examples of other medications that may be used with Remicade to treat symptoms of plaque psoriasis include:

  • topical corticosteroids, such as betamethasone
  • topical calcipotriene
  • coal tar

Many of the conditions that Remicade treats can also be treated with similar additional medications. Talk with your doctor about the safety and effectiveness of all over-the-counter or prescription drugs youre considering for your treatment.

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What Happens During Remicade Infusion

Remicade is given by intravenous infusion. Dosage depends on how severe your ulcerative colitis or Crohns disease is as well as your weight. Your doctor will calculate the dose that is right for you. The nurse will prep your arm by sterilizing the area with rubbing alcohol. The IV needle will be inserted and held in place with tape. Remicade will be infused into your bloodstream. Vital signs will be monitored every 30 minutes during the infusion. During infusion, youll be carefully monitored by a nurse or other healthcare provider. This process usually takes about two hours.

The Potential Downsides Of Biologics

While biologics may be a promising option for treating your ulcerative colitis, not every drug is suited to every patient.

We will work with patients for a while to tailor a treatment plan that is right for them, says Dr. Raffals. That may mean trying different biologics and small-molecule drugs, and, of course, taking into account what the patients insurance will cover.

A persons lifestyle, demographic factors, and the severity of the disease are all considerations in the choice of whether or not to use biologics, and which of them is the best option.

Some potential downsides of taking biologics include:

If youre considering biologics for treatment, speak to your doctor to find out whats best for you. As Tsynman says, At the heart of the decision is the relationship between the patient and the physician and specifically exploring what works best for each individual.

Additional reporting by Jordan M. Davidson.

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