For chronic Pouch inflammation antibiotics would be the first line of treatment and biological drugs like Remicade or Entyvio would be the second line of treatment.
Budesonide/Entocort was in my case only used as a supplemental treatment when the antibiotics started to not work as well. It did help me somewhat, but inevitably I ended up on biological drugs.
Remicade is generally favored over Entyvio as a first option biological due to empirical evidence of effectiveness (clinical trials) on chronic Pouch inflammation. I am on Remicade 3 plus years now with no side effects and it cleared up the inflammation in my Pouch but hasn’t worked as well on the scattered inflammation and ulcerated areas above the Pouch in the neoterminal ileum. Entyvio is my doctor’s second option. The one advantage with Entyvio is shorter infusion time- 30 minutes vs. a little over 2 hours for Remicade.
You sound like you should be on biologics and I would ask your Doc if he or she has a reason for favoring Entyvio over Remicade besides the infusion time. I am interested in hearing the reasoning on it.
Shorter infusion time means convenience for the patient and also more money for your doctor’s office as they can move more patients in and out of that infusion room. They have the same reasoning for using propofol over conscious sedation on scopes, despite propofol being 15-20 times as expensive at retail. They want to move patients in and out and collect the extra insurance $. Don’t allow yourself to be persuaded to have treatments that are perhaps less efficacious than others because they are “convenient” or make more money for your doctor. Do what is right for you and you illness.