heavyweat...... on the body causing a need to increase the dosage?
Have been on Remicade to treat Pyoderma Gangrenosum for almost a year (every eight weeks) and suddenly it seems like the medication isn't working and my wound has become wounds with a topping of Santyl debriding gel and a SoloSite Hydrogel bandage on the primary ulcer. I am due to have another infusion in early August. Not sure what to think.
Is anyone aware of a "rebound effect" as the body's immune system catches up to the Remicade assault
- Posted:
- 12 Jul 2012 by heavyweather
- Topics:
- remicade, ulcerative colitis, inflammatory bowel disease, pyoderma gangrenosum, crohn's disease, crohn's disease -- maintenance, dosage, medication
Details:
Added 2 Aug 2012:
August 2, 2012 update - Answered my own question...
from the prescribing information...
Treatment with Remicade can be associated with the development of antibodies to infliximab. The assay used to measure anti-infliximab antibodies in patient samples is subject to interference by serum infliximab, possibly resulting in an underestimation of the rate of patient antibody formation. The incidence of antibodies to infliximab in patients given a 3-dose induction regimen followed by maintenance dosing was approximately 10% as assessed through 1 to 2 years of Remicade treatment. A higher incidence of antibodies to infliximab was observed in Crohn's disease patients receiving Remicade after drug-free intervals >16 weeks. In a study of psoriatic arthritis in which 191 patients received 5 mg/kg with or without MTX, antibodies to infliximab occurred in 15% of patients. The majority of antibody-positive patients had low titers. Patients who were antibody-positive were more likely to have higher rates of clearance, reduced efficacy and to experience an infusion reaction [see Adverse Reactions (6.1)] than were patients who were antibody negative. Antibody development was lower among rheumatoid arthritis and Crohn's disease patients receiving immunosuppressant therapies such as 6-MP/AZA or MTX.
Responses (1)
always hope12 Jul 2012
My wife could only stay on it for 3 months as she ended with sepsis and multiorgan failure.. They withdrew all treatment.. I dont think it had anything to do with Remicade. Her ulcers were treated using Hyperbaric Oxygen Therapy using a 100 dives. It reduced everything signifcantly and then it got a Pseudomonas infection and has gone back to as bad as ever. Have you joined PG Group on Facebook- really helpful and there may well be others with more useful info for you
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Hello always hope. Thank you for sharing, and I am very sorry for the loss of your wife. Be well, as you said, there is just that, always hope. Best of wishes, pledge
Just to clarify. My wife has come through it all but PG is only very very slowly improving. Remicade has been allowed if necessary by the NH Trust but in meantime she is on anti rejection drugs
I am sorry to hear about your wife's ordeal "always hope". What a nice person you are adding to my thoughts. Thank you. When I was getting set for my last Remicade infusion the nurse wasn't sure that she liked what my ulcer looked like... so a doctor had to inspect my wound prior to opening the IV line. When the Gastroenterologist heard that it was getting ugly - he suggested the rebound effect. (duration: just shy of a year - every 8 weeks - with no significant effect one way or the other) It is even worse now with one ulcer being surrounded by four less significant but messy wounds - getting worse by the day. They sure look like tape burns - but I only use gentle paper tape. I mentioned Hyperbaric Oxygen Therapy to my Vascular Surgeon about a week and a half ago. He said that he didn't know how an hour or two of increased oxygen out of twenty four would significantly change the healing process.
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I'd like to give it a shot because we know that it doesn't hurt. I had no idea that a PG group existed on Facebook. I guess I shouldn't be too surprised. Hopefully that won't turn into a flag on my page - as there are other things that I'd rather be known for... I will look into that group this afternoon. Best wishes to both you and your wife. Thanks very much for taking time to write.