After Remicade (infliximab) and Humira (adalimumab) failed me — along with sulfasalazine, mesalamine, and budesonide — I started the biologic Entyvio (vedolizumab) last June as my main Crohn’s disease management medication. I still didn’t enter clinical remission, so I began Stelara (ustekinumab) on Feb. 5.
As I mentioned in a previous column, “Crohn’s Disease Medications: Part Four in a Series,” the treatment plan my doctors used is like a pyramid. Therapies that have the least number of side effects, or are least harmful, are at the bottom of the pyramid, so we start with them.
Some use the same pyramid, but inverted, starting with the aggressive, potentially more harmful medications first. While these treatments may induce remission, other less dangerous medications may work for some patients, too. Discuss options with your care team.
These options can include steroids like prednisone and budesonide, immunosuppressive medications like methotrexate and azathioprine, anti-inflammatory medications like sulfasalazine and mesalamine, and biologics like Humira and Remicade. I have tried everything except methotrexate in my journey to remission, so far.
According to the Stelara website, “Stelara is the only FDA-approved medicine that targets [proteins] IL-12 and IL-23, which are thought to be associated with gastrointestinal inflammation in Crohn’s disease.”
With only one infusion as a loading dose followed by skin injections every eight weeks, it’s possible to only have around six treatments a year, even at home! With Stelara, an initial infusion is needed for a loading dose.
My infusion usually takes a few hours, for preparations, getting hooked up to the machine, starting the IV and saline drip, waiting for the Stelara mixture from the pharmacy (dosing based on my weight), and then an hour for the medication’s administration. I bring headphones, a blanket, and a stuffed rectum plush from I Heart Guts with me, along with more items I shared in “Entyvio Infusions for Crohn’s Disease and How to Prepare.”
After this sole infusion, Stelara will be given to me by injections. I’ve done the Humira shots and prepared for fertility shots, so I feel comfortable giving them to myself — I plan to do it every eight weeks.
Like any medication, Stelara comes with the risk of infections because of a weakened immune system, liver problems become a complication worry, and serious allergic reactions are always a concern.
Your doctors may suggest a different treatment plan from what I have tried. I cannot, and would not, offer medical advice. I can only share what I know from my personal experiences. Remember, Crohn’s disease is different for each patient, and what works for me may not necessarily work for you.
Crohn’s disease and ulcerative colitis have no cure, and complications from them can worsen over time without remission.
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