Is my GI switching biologics too quickly?

Question

Looking for some advice from people who have been on Stelara, as well as just advice in general.

I’ve been in a UC flare since January. I’ve gone through a couple rounds of prednisone, and currently I’m taking 40 mg every other day while waiting for Stelara to hopefully kick in. Taking 4.8g daily of Mesalamine as well.

I failed Entyvio earlier this year. My GI decided it wasn’t working after about 10 weeks and switched me to Stelara. I had my first Stelara IV infusion 7 weeks ago.
The thing is I actually feel better now than I have at any point during this flare. I’m definitely not in remission, but I finally feel like I’m moving in the right direction. I’m slowly starting to do things I used to to an extent like light exercise and going on short outings.

Current symptoms:
About 5–7 bowel movements a day. Down from upward of 12-15
Usually 1–2 bowel movements overnight. Down from 4-5.
Stools are still loose, but not as watery as before. Something I’ve also attributed in the past to the low fiber diet my gastro recommends.
Still have urgency, although I’ve started having a few “normal” urges instead of every trip being an emergency.
Still get abdominal cramping, especially before bowel movements.
No fever, chills, or nausea
Has been a couple of months since I’ve seen any noticeable blood.
I’ve regained a few pounds after dropping weight, but I’m still below my pre-flare weight. Down to 130 from 155 but back up to 136.

From everything I’ve read, Stelara can be one of the slower biologics to work, sometimes taking several months for the full effect. My GI is already talking about switching me to another medication because I’m not where they want me to be yet.

She’s also suggested that I go to the ER for IV steroids. I understand that can be necessary in some situations, but I’m struggling to see the benefit in my case since I’m feeling better than I have in months, and it seems like a temporary bandaid if anything. Between spending hours in the ER, the cost and insurance concerns, and the fact that I’m seeing gradual improvement, I’m hesitant unless it’s truly necessary.

Has anyone had their doctor recommend IV steroids even though you were improving? Did it make a significant difference compared to staying on oral prednisone?

Also, for those who responded to Stelara, did you continue to improve after 7 weeks? How long did it take before you noticed a major difference? Is it reasonable to give Stelara more time before calling it a failure?

Posted Jul 10, 2026, 7:25 PM UTC

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