Switching Biologics (Again)

By Steff Di Pardo

2 min read

I have once again switched my biologic medication! I’ve been on Inflectra, Humira, Cosentyx, and now, drumroll, please...Remicade!

Remicade is chemically very similar to Inflectra, which is actually a biosimilar of Remicade. This is my fourth drug in 5 years of being diagnosed with AS.

Why I switched

Once again, I found myself in a position where I was starting to feel worse. I was feeling increased pain for months, as well as increased fatigue. My last dose of Cosentyx was on Halloween, and all throughout November, it hadn’t helped me one bit.

In addition to the increased symptoms, I was diagnosed with microscopic colitis in August, and there were no findings of Cosentyx helping Colitis at all. Remicade helps with ulcerative colitis, so we decided to switch and give it a try for my MC.

I had an appointment with my Rheumatologist in early November where we discussed everything that was going on with both my AS and my MC and landed on Remicade as the next step in my treatment process.

The wait

I really only waited 30 days for my new treatment to begin, but let me tell you, that 30 days felt like an eternity. With the increasing pain and fatigue, I was less able to do things as the days went on.

I got a call relatively soon after my appointment and things were being set up for me with my new treatment, which I was so excited about. Does anyone else get overly excited to start new medications? I know I shouldn’t put so much hope into one medication, but I’ve lived with AS and been on treatment long enough to know that if one treatment doesn’t work, there are others out there for me to try.

Then, November 30th came! The day I got to start Remicade!

The process

If you haven’t had an infusion before, I’ve written about it when I was on Inflectra, but I will give you a little rundown! I showed up at the infusions clinic bright and early and was unable to sleep the entire night due to anxiety and excitement.

I sat in the chair and waited while the nurses prepared my medications. I was excited to start my new drug, and hopefully get the process of feeling better started! I took my pre-meds of Tylenol and Benadryl as well.

I usually don’t do well with needles in my veins, so I know now to take deep breaths and look away. That’s just about the best I can do to prepare myself for the IV.

The nurse put the IV in with some saline and soon after started my Remicade infusion. It lasted 2 hours, with an additional hour afterward to monitor me for a reaction (which I didn’t have, woohoo!).

It was a very simple and peaceful process. I brought my laptop and watched podcasts and streams on Twitch until it was over, which felt like it was over in the blink of an eye!

How I’m feeling now

A week after the first infusion, I’m still feeling incredibly fatigued. I know this is possible with starting new meds, so I’m trying not to be too upset about it, but the fatigue is very overwhelming.

I have my next infusion a week from now. I’m still on the loading doses and will be until mid-January, and hopefully, things will look up from there!

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celestialwonder Member
This article has perfect timing. I am resting in bed from fatigue and pain debating whether to switch from Humira to Remicade as I face the prospect of returning to work full-time. I think "How am I supposed to pain manage?" Yesterday it took me two hours of soaking, stretching, smoothies, and rest to get my pain back to a tolerable level. How did I do it before? Maybe the anxiety is exacerbating the pain. Anyway, please keep us updated! I am really interested in hearing how you fare on this new med. (Though I know it is different for each person).
Tich Member
Wow, this brings back memories of my failing decade with TNF inhibitors. From 2006 to 2017 we tried everything approved for AS but none gave me relief from my primary disease, Anterior Scleritis which was/is believed to be secondary to Ankylosing Spondylitis… at least in my case. I’m sure the trouble was worth the hassle of changing meds. My employer was extremely helpful and supportive, but the scleritis pain was too much. I had to rely on high levels of oral prednisone pills which caused glaucoma and cataracts. Turns out I was a steroid‘responder’. Finally I was referred to an optical immunologist who recommended changing from Cosyntex to Rituxan. This seemed to help but didn’t stop the eye inflammation. Exhausted in every way I had to stop working. After 38 years I was only 59 yoa so not yet pension eligible. I applied for disability, not realizing that would be even more stressful. But it came through and that gave me more time to rest and search for an alternative to steroids. I found many people in the world-without-Big-Pharma use low-dose radon therapy to reduce inflammation, especially for Ankylosing Spondylitis. I began my own treks to Montana for this far-out option. After my second visit to the radon spas my eyes improved and I was able to stop using steroids. Eventually
Lisa Marie Basile Moderator & Contributor
While it truly is challenging that you’ve had to switch medication a few times, I’m so glad that you have the chance to access new medication‘s and to hopefully find some thing that will treat both your AS and your MS. I hope it works out for you, and thanks for running down the infusion process for us!
Lawrence Rick Phillips Moderator & Contributor
 I thought Remicaide was the very best medication I have used. Until it was not. After about 5 years it stopped suddenly. I then had a string of TNF inhibitors and am now on an off label B cell inhibitor. But back to Remiciade, I hope it works wonders for you. 
1. Lisa Marie Basile Moderator & Contributor
 <inline-mention username="Rick Phillips" user-id="2389838"/> gosh I’m so sorry to hear this. Such an unfair trade off. I wish there was something that can allow you to live life and also give you the reprieve from AS. Are your doctors supportive? Sending you lots of strength
2. Lawrence Rick Phillips Moderator & Contributor
 <inline-mention username="Lisa Marie Basile" user-id="2390344"/> They are. Like most of us who use this medication (Cancer, RA, MS among others) this business of suppressing the B cells is usually fine, except for vaccinations. We have started to rely on Evushield but just this evening it was pulled because it is not effective against the most prevalent COVID variant. It is difficult. But we are hopeful we will get a better outcome soon.
James Hollens Moderator & Contributor
Hey <inline-mention username="Steff Di Pardo" user-id="2397373"/> , Sorry that you are having to go through the process of switching medications once again - let's hope that this is the case of fifth time lucky! Glad that the infusion process went well and you were able to relax for a bit with your podcasts. I hope that the fatigue from this all comes to an end soon and you are able to start seeing some big results shortly! How are you getting on now that you are near the end of your loading doses? Wishing you all the best, James (Community Member)