Crohn's Disease Forum » Treatment » Remicade/Infliximab » Is Humira and Imuran a good combo?


 
02-09-2010, 08:53 PM   #1
uab grad student
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Is Humira and Imuran a good combo?

I was really crossing my fingers that the Humira I started on December 28 would kick in by now.

Unfortunately, it isn't. Entocort works wonders--doesn't make me "normal" but makes me quite functional. I'd just keep taking it, except my doc says he doesn't want me on steroids long-term due to the side effects. Even though I'm on Humira, if I go off the Entocort, even for just a few days I'm in BAD pain. Augh!

So, went to the doc today and got many tests--doc says when they come back, he'll start me on Imuran in addition to my Humira shots.

So, I guess my question is, has anyone on here taken both the Imuran and Humira and had good results? If you were on entocort/prednisone, did it allow you to go off steroids and not suffer badly?

Just trying to stay hopeful but this flare is really getting me down...
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Ashlee

December 2009--Diagnosed with Crohn's

Current Crohn's meds: entocort, remicade, 6-MP

Other stuff: pulmicort, pro-air, celexa

Current supplements: ferrous sulfate, folic acid, Vitamin B12, Calcium, Vitamin D, women's multi-vitamin, Florastor probiotic

Last edited by uab grad student; 02-09-2010 at 09:19 PM.
02-09-2010, 10:02 PM   #2
uab grad student
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or has anyone had improvement with Imuran alone? Basically, I would like any of your answers... Kind of unsettled right now.
02-09-2010, 10:05 PM   #3
katiesue1506
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I'm currently on that combo. I take 150mg of Imuran and Humira every other week. Basically the Imuran is supposed to keep my immune system from eating up the Humira too quick. So far I've been managing my condition pretty well with this combo and Pred for about 8 months.
02-09-2010, 10:07 PM   #4
uab grad student
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Thanks katiesue. That's just the type of positive reassurance I need. :-)

Have you lost a lot of hair? Just wondering as my doc said this could happen
02-10-2010, 11:33 AM   #5
kenny
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I am on Imuran alone. It reduces your overall immune response and is very handy when dealing with external manifestations of the disease such as Arthritic pains. I have only taken it for a month at this point, but I feel as good as I could wish for right now. They are using it on me to help close two small fistulas that appeared at the resection site post surgery. I do not have extensive inflammation anywhere of note and will get a follow up scope in a few months to check things out.

I am not experience any side effects so far that I can notice. Maybe a few hairs on the pillow each morning but as a guy in his early 40's that to be expected anyway
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02-10-2010, 01:02 PM   #6
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Thanks Kenny. I'm glad you haven't experienced too much hair loss... I guess if I do, I will get a wig. My hubby said, "you know hon, you can get hair replacement but you can't get gut replacement". So, I am gonna give it a shot! I'll let everyone know how this works out. I should be starting it in a few weeks as long as all my tests come back OK.
02-10-2010, 01:03 PM   #7
uab grad student
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BTW, Kenny, I noticed it wasn't too long after your diagnosis that you had to have surgery... this is what I'm trying to avoid. Did you have a stricture, if you don't mind my asking? I have a 6 in stricture in my ileum and they are treating me aggressively to avoid having surgery before I graduate with my PhD. I'm just hoping I can hold out.
02-10-2010, 08:36 PM   #8
kenny
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I was pretty swollen at the terminal Ileum and was put on a liquid diet for all of August and September leading up to the surgery. But the main issue was three fistulas, all originating near the Terminal section of Ileum. One insignificant recirculating back to the small bowel, One Driving all the way up to my Transverse colon, and the nasty one that burrowed into my abdominal wall and created a 6" long abscess.

If they did emergency surgery they feared they would have to take out quite a bit of Ileum and colon to get to something that could be stitched together at the time. So we decided to go elective and it took that time for me to stabilize and get a OR slot. I spent all of August and September with a drain tube inserted into my abdomen to drain the abscess and it kept draining GI material the whole time. Sort of like a mini stoma only it was a thin plastic tube. I ate flagyl and Levaquin for antibiotics four times a day and did not eat anything I had to chew. Could not have been sooner for me

Eat a lot of liquid stuff and do not let yourself tense up. I hope you hold on until you can sacrifice the time for surgery and recovery
02-11-2010, 06:30 PM   #9
Kev
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I've never been on Humira, so I can't speak on it. But, I was on Imuran (aka AZA, azathioprine, poison... ok, not really) until it went toxic on me and I ended up in the emergency room. That was not a fun experience, believe me.
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Dx'd July, 2006
Meds: Flagyl, Cipro, Pred, AZA.. to no effect
Low Dose Naltrexone Nov 2007 - May 2014
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02-11-2010, 11:06 PM   #10
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Good luck, Erazer! I see you are actually more of a Crohn's veteran than I am. I would think getting the inflammation under control is a first priority for you now so you can minimize any further operations, so I hope Imuran works well for you.
02-11-2010, 11:08 PM   #11
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Kev said:
I've never been on Humira, so I can't speak on it. But, I was on Imuran (aka AZA, azathioprine, poison... ok, not really) until it went toxic on me and I ended up in the emergency room. That was not a fun experience, believe me.
Yikes! How did you know you were having a severe reaction to the Imuran? Just wondering so I can watch out for anything and run to the hospital ASAP if I have the same unfortunate response.
02-11-2010, 11:20 PM   #12
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kenny said:
I was pretty swollen at the terminal Ileum and was put on a liquid diet for all of August and September leading up to the surgery. But the main issue was three fistulas, all originating near the Terminal section of Ileum. One insignificant recirculating back to the small bowel, One Driving all the way up to my Transverse colon, and the nasty one that burrowed into my abdominal wall and created a 6" long abscess.
Thank God I don't have any internal fistulas at the moment! I've had a couple of anal fistulas but none stemming from the bowels. We're hoping that I'll be able to improve the narrowing of my terminal ileum by reducing the inflammation--the scar tissue will of course still be there but hopefully we can slow the progression so that things can be "stable" for a bit longer.

kenny said:
Eat a lot of liquid stuff and do not let yourself tense up. I hope you hold on until you can sacrifice the time for surgery and recovery
I have been avoiding stress as much as possible and I have been drinking a lot of boost, carnation instant breakfast, and blended soups. I'll crave something crunchy but regret it within an hour or two of eating it, so no corn chips for me now!

Thanks for the advice.
02-12-2010, 04:10 PM   #13
mharvey90
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hey there, i'm currently on 150mg imuran and humira EVERY week, which is a lot of both for my weight (~140lbs) I've been on the imuran for at least 6 months now, and humira for a few. i'm not getting any better, but i've just stopped responding to meds and i'm getting surgery in May. I was doing well on remicade/imuran combo, until i developed an allergic reaction to remi
02-13-2010, 01:22 PM   #14
kenny
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I had a touch of D and cramping the first 10 days or so but it is so hard to attribute that to Imuran with all the other ibd woes we have. I have not had D in two full weeks now. Any symptoms of cramping/craping I have I can duplicate with a specific food I tried.

I feel that at 3 weeks I passed the side effect phase for Imuran.

About the liver thing. I believe that is due to the lack of an Enzyme that is responsible for converting the drug. It is a natural variance in people and the reason for the regular blood work people get done while taking this type of drug.
02-13-2010, 10:15 PM   #15
kenny
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Erazer said:
Hi Kenny!
Sounds like you and Imuran have become good buddies......hope it will always be a great relationship!

I am hoping for the same results!

What about hair loss..........but I suspect it takes many months for that side effect to to appear. Seems to affect women more then men.......STRANGE role reversal there!
I hope it works as well for the crohns as is has for dumbing down my allergies and arthritic pain. I have been on Cox2 drugs like Mobicox and Celebrex for several years to help with pretty nasty joint pain and swelling. I have taken Flovent for allergy induced Asthma for as long as its been around! And I have had issues with allergic reactions since I was born. Since a minor bit of IBD turned into full Blown Crohn's this past year, everything just seemed to point to immune suppression as the best way to go. Imuran is mostly prescribed for rheumatoid Arthritis these days as I guess they have better things for Organ transplant patients. But you can see how it fits my particular case quite well.

I don't see much with the hair loss so far. I have been too worried about my guts going all wonky to care about my thinning moptop
02-15-2010, 02:17 PM   #16
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mharvey90 said:
hey there, i'm currently on 150mg imuran and humira EVERY week, which is a lot of both for my weight (~140lbs) I've been on the imuran for at least 6 months now, and humira for a few. i'm not getting any better, but i've just stopped responding to meds and i'm getting surgery in May. I was doing well on remicade/imuran combo, until i developed an allergic reaction to remi
Sorry didn't check on this thread for a few days...

Anyway, that is a BIG dose of imuran and Humira you are on. I hate that you aren't getting any better... do you have a lot of scar tissue/stricture? You will have to let us know how your surgery goes in May. From what I understand, getting elective surgery is better than the alternative (emergency) since you can increase your nutrition prior to and it will also hopefully be more bowel-sparing. I wish you the best with the procedure.
02-15-2010, 02:20 PM   #17
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Thanks Kenny and Erazer for your responses. I'm comforted to hear that the Imuran side effects die down after a few weeks. Keeping my fingers crossed that this is THE drug for me.
02-17-2010, 09:04 PM   #18
mharvey90
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Erazer said:
Hey mharvey90!
Did you experience any major hair loss from Imuran?!? What about stomache discomfort? It's probably hard to know what symptoms were from what drug! Sorry to hear u need surgery.......what are u having done? Good luck with it all!!
Yep, absolutely. I have really thick curly hair, so I tend to shed a lot of hair normally. But in the past 10 months or so since I've been on azathioprine, I have been losing hair in ridiculous amounts, mostly in the shower. I won't complain though, because I have enough hair on my head for 5 people!
02-17-2010, 09:06 PM   #19
mharvey90
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uab grad student said:
Sorry didn't check on this thread for a few days...

Anyway, that is a BIG dose of imuran and Humira you are on. I hate that you aren't getting any better... do you have a lot of scar tissue/stricture? You will have to let us know how your surgery goes in May. From what I understand, getting elective surgery is better than the alternative (emergency) since you can increase your nutrition prior to and it will also hopefully be more bowel-sparing. I wish you the best with the procedure.
yeah, that's how I feel too. I'm just afraid of how suppressed my immune system is! I don't want to get sick with anything else, even though I got both my flu shots in the early winter. And yes, I have major scar tissue build up which is contributing to my stricture. I can't wait to just get it out and start to feel better. Thanks
02-18-2010, 07:03 AM   #20
gibby
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I started imuran 8 years ago when i kept flaring on my pentasa, and needed repeated courses of prednisolone. i got an enzyme test done for a TMPT level, which is responsible for breaking down imuran, and if you have too little of the enzyme it can lead to a reaction. so that was done before i started it, and if it had come back low i wouldnt have been able to commence it...

...but it didnt, and i started it, no problems exept a bit of hair thinning, but to be honest i dont really notice unless i am on prednisone which seems to aggravate the process. Moved up to 150mg a day reasonably quickly with no real issues and stayed on it problem free until now!

...not been as controlled the past 6 months so looking like i will be changing meds soon, but it gave me so much relief, and not having to be on prednisolone as much really helped.

but i'm on it now....hey ho...

hope its as good for you guys as it was for me!
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Dx UC 1991 when i was 8 years old:

Hospitalised for 2 weeks in July 2011 with burst appendix and peritonitis, surgery, IV antibiotics and a long recovery...

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*8x500mg Pentasa (Mesalazine)
*3x50mg Imuran (Azathioprine)
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*Asacol PR when flaring +/- prednisolone

03-08-2010, 11:27 PM   #21
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So I went to the doctor and I've been changed from Humira to Remicade, staying on the Entocort, and have been put on 100 mg of 6-MP (which doctor said is similar to Imuran)...

Still waiting for relief and my gastroenterologist is leaving at the end of this month. :-( I know it is selfish, but I just wish she wouldn't leave until I was out of this flare.
03-09-2010, 03:09 AM   #22
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hi this is bindi..im on 175mg of imuran and the humira plus im on 5 mg of prednison. i started out on 30 and have been tapering every 2 weeks. to start with the imuran wasnt working well enough so the doc put me on the humira and the prednisone. after a few weeks the infamatory markers were down and i wasnt having any trouble.. i havnt had any hair loss just the puffyness and hating that day that comes around every 2 weeks when i have to stab my self lol. not sure what will happen thought when i go of the prednisone altogether though! hope the new meds work for you!!

bindi
03-10-2010, 12:56 AM   #23
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I hope it continues to work for you Bindi. It's great that your inflammatory markers came down so quickly!
04-17-2010, 11:05 PM   #24
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Hey, Ashlee! I found this thread again as I should be starting on Imuran soon in addition to Humira. How has it been going with you?

For others who have taken or are currently taking Imuran, is it a standard procedure to get tested for the enzyme to break it down before starting it? My doc hasn't mentioned anything about it.
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February 2010 - diagnosed with Crohn's disease.
January 2011 - Inflammation downgraded from moderate-severe to mild with no symptoms!
January 2014 - adopted a mostly Paleo diet
May 2015 - still in remission!


Currently Taking
Humira - 40mg/week
Imuran - 125 mg/day
Calcium magnesium citrate
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04-18-2010, 10:37 AM   #25
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I read a study that says combining biologics with immuran or 6MP increases the chances of remission by quite a bit.
04-18-2010, 11:41 AM   #26
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Yeah...I read that somewere too, Lydia. My GI is a fan of the "top down" approach. Using the strongest combination of meds possible to kick me into remission. And I also didn't get this one he was talking to me about aza (thank goodness for my hubby being there for an extra pair of ears!), but he only wants me on it for like a year (hopefully by then I'll have tolerated it and reached remission) and then keep on with the Humira. So, that's encouraging. Now to just get there and tolerate it well! I think I'm definitely needing something because I started flaring again yesterday...wah...
04-18-2010, 02:25 PM   #27
Astra
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Hi Marisa & Ashlee
hope you're well?

My gastro mentioned the 'step up approach' too, eg, Pred to control the pain first, then a biologic (me)
and the 'step down approach' is an immuno supressant eg, Aza with a biologic,
and according to 'The Lancet' the 'step down' is more effective.
xxx
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BEEN ON -Azathioprine, 6MP, Prednisolone, Pentasa, Budesonide, Metronidazole, Humira, Methotrexate,

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04-18-2010, 02:45 PM   #28
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Well, it's comforting to know it's proven to be more effective
08-08-2012, 12:18 PM   #29
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Hi everyone, I'm pretty new here. My Humira doesn't seem to be working well, I've been on steroids with it for a while now and I had 2 bowel obstructions in a 6 week period. They did dialate my ileum where I had some narrowing and scar tissue from a resection I had in 2000 but I still have symptoms. I'm supposed to taper down a bit on my prednisone this sunday (5 days from now) and if I continue to have problems then I will be going on a half dose of azathioprene added to the Humira. I have to say I'm pretty scared about this what with the talk about lowered bone marrow production and hair loss and the fact that I will be on all 3 drugs for a while until I taper off the prednisone. I'm trying not to worry about it but I'm not doing such a good job of it right now. The doc did say that this combo was safer than going on weekly Humira shots so I'm hoping that is honestly and truly the case and I don't end up catching every illness that comes along. Nancy
05-02-2018, 08:12 PM   #30
thike1966
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I'm on Imuran and Prednisone hanging on since Remicade failed me into allergic reaction. I had to wait for 6 weeks to clear out the Remicade and have been waiting 2 more weeks for approval which I got yesterday. Monday I go to G.I. office with my Humira arriving on Thursday. Imuran was prescribed after Remicade crash, both keeping me out of the hospital, thankfully living with prednisone side effects such as blurry vision that will hopefully clear after prednisone is DONE.

Last edited by thike1966; 05-02-2018 at 08:15 PM. Reason: Humira, Imuran and Prednisone
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