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Crohn's Disease Forum » Treatment » Remicade/Infliximab » No Detection of Neutralizing Antibody Titer with Remicade


11-16-2015, 10:39 AM   #1
athena
 
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No Detection of Neutralizing Antibody Titer with Remicade

Hello!

I am just looking for some advice to what is next. I just had my 4th Remicade treatment, and had to get blood work right before the infusion. My test results came back today and stated that there was no detection of Neutralizing Antibody Titer. The advice under this disheartening result was "a change to another type of therapy (not targeting TNF-alpha) may be appropriate."

I was wondering what else can be done? What other treatments are out there?

I am fairly new to Crohn's (Diagnosed December 2014). I am just so lost and confused to what is next.

Thank you all!
Athena
11-16-2015, 10:50 AM   #2
Clash
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What did it state the inflixamab activity was?
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Mom to
C age 19
dx March 2012 CD

CURRENT MEDS: MTX injections, Stelara


Dx May 2014: JSpA
8/2014 ileocecectomy
9/2017 G tube

PAST MEDS: remicade, oral mtx, humira
11-16-2015, 10:57 AM   #3
athena
 
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Yes! It said that the activity was 4.37.. I have no idea what that even means.
11-16-2015, 11:20 AM   #4
Clash
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Have you spoken to your GI yet? Do you have a follow up appt? Or plan to contact the GI nurse after results come in?

On a sample lab it did indicate transferring to a non tnf biologic is the inflixamab activity level was greater than .65 but honestly I'm not sure of the explanation.

With my son they want the level of remicade to be present and viable and the antibodies to be undetectable.

MLP do you have any insight?
11-16-2015, 11:22 AM   #5
Clash
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Here's a link to sample lab results. Once on this site click on the first sample report link highlighted blue and titled interfaced report:

https://www.aruplab.com/immunology/ifx
11-16-2015, 11:26 AM   #6
athena
 
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I have tried to call my GI, but ended up leaving a message with the receptionist. Hopefully they'll tell me something good! I guess I just don't know much about other medications, especially those that are not meant to target TNF-alpha.
11-16-2015, 11:46 AM   #7
Clash
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There's entyvio, it's a biologic not based in tnf. And to hers that can pxed off label if they haven't been approved for CD yet. I think Stelara has shown improvement for some.
11-17-2015, 01:43 PM   #8
athena
 
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Thank you for your help! (: It is greatly appreciated! I still haven't heard from my GI. /: Hopefully they'll call today!!
11-20-2015, 07:51 PM   #9
athena
 
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I actually talked to my doctor, and they said that they want to increase my Remicade.
11-20-2015, 08:24 PM   #10
Clash
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Hopefully that helps!
12-04-2015, 12:02 PM   #11
EvieBaby
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I got told last week that this could be me and I'm waiting for the results if my blood test. Apparently some people have antibodies that fight the medication making it useless. I've had no benefit from having this medication so they think this could be happening but I'm waiting to hear. It scary because nothing else has worked and I don't know what the next step would be!

12-04-2015, 02:16 PM   #12
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My son had to move on from remicade due to antibodies. Here's some info about remicade and the other biologics.

One third of patients will not respond to anti-tnf therapy.

- If you don't respond to a biologic, you are a "Primary nonresponder".

- If you don't appear to be responding to a biologic, it's important that your physician make sure it's not due to something else such as, strictures, fistulae, abscesses, c.diff, small intestine bacterial overgrown (SIBO), CMV, bile salt diarrhea, etc.

- You should have your full induction dosing before being termed a primary nonresponder.

- For Remicade, some suggest the full induction dose then, at the 6 week dose, double the dose before determining non-response.
Source
http://www.crohnsforum.com/showthrea...Switching+anti

Also when testing for antibodies they should also test your trough levels if those are low then dosing, schedule or both need to adjusted.

Taking methotrexate, imuran or 6mp with remicade has been shown to help prevent the body from antibody formation. Meaning, if the test is negative for antibodies at this time adding one of those meds might help prevent it from ever being a problem. Also those meds can give the remicade a synergistic effect(a boost)
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