23 year old male had remission, until now; help make decision

[Sir Peaches]

hi new to forum, gonna try and keep it short and sweet. i am 23 years old diagnosed with Crohn's at 4-6 years old. i was not doing well for a while, until about 14ish i got put on prednisone and 6mp, after starting 6-mp i stopped prednisone. i continued 6-mp and after a few years of feeling fantastic the doctor weened me off it. went from ages of about 17ish to 22 without a single problem. felt fantastic; ate what i want, drank what i wanted as well as worked out very hard (natural bodybuilder). now at the age of 23 i have been getting pains and went to the doctor and after a ct scan i have little narrowing/stricture (2.8cm) of the lower left abdomen. i started prednisone yesterday until i figure out if i should take Humira or start 6-mp again. i am afraid of taking humira because of the sides as well as other reasons. 6mp has worked well with no sides for me but is it ok to go back to 6mp. i am very very afraid to have surgery and want to avoid it at all costs in the future, what are your thoughts; going to doctors tomorrow for second opinion; first opinion was to take humira cuz it works faster. any advice or questions to ask doctor tomorrow is greatly appreciated too.

 

[theOcean]

It should be all right to go back on 6mp, but I would do so while on a short course of prednisone. It's only with biologics like Remicade/Humira you have to be worried about building up antibodies to them if you've stopped them. If the 6mp on its own is not enough, you may want to consider going on it in combination with Humira.

Keep in mind 6mp takes about three months to get to a point where it's therapeutic.

 

[Sir Peaches]

yea im gonna ask the doctor tomorrow if i can do 6mp instead of Humira, i mean it worked before so i dont see a reason not to use it to open up my intestines again. would there be any downfall to picking 6mp again over Humira? i figured maybe i should save the Humira till things get more serious. and yes prednisone alone is enough for my stomach to literally feel back to 100% normal so i have no doubt that 6mp alone will be more than enough to handle it, so i doubt id need to be on anything with 6mp...thoughts on the subject are really really appreciated, idk where else to turn since doctors just do not seem to care at all (ive been to countless)

 

[theOcean]

They're pretty different medications, since one is an immunosuppressant and one is an antibody. Humira is a biologic so it's what I'd consider to be one of the strongest medications you can be put on. I take it because my case is so severe and haven't had any problems with it.

It sounds like prednisone and 6mp should work just fine for you, though. You only need to consider a biologic if that stops being enough. In people with milder cases they're also put on a 5-ASA (like Asacol or Pentasa) but that's not effective for all people with Crohn's. 5-ASAs are just glorified anti-inflammatories, though, whereas 6mp is an immunosuppressant that should stop the inflammation from occurring in the first place.

 

[Sir Peaches]

i wouldnt say my case isnt severe but (no offense) definitely not as serious as yours (sorry to hear ) i have had the serious years with it and it was super painful but i figure since it isnt as serious atm i dont see why it would be a problem taking a weaker medicine that still works for me and save humira for the future...is that the wrong thinking? also is 2.8 cm narrowing very serious? ive been on prednisone for only 24 hours and already feel 100% better, i seem to respond really well to prednisone as well as 6mp...

 

[theOcean]

If the weaker medication works for you, I don't see anything wrong with sticking with that for now! It's only if it fails to get you into remission that I would consider taking something stronger, so there's nothing wrong with your thought process about it. Just make sure that you continue taking the 6mp even after you go into remission, since it's good at keeping you there.

I personally don't have experience with narrowing, so I can't say for sure if that's particularly bad or not. If you feel like the prednisone is helping that much, though, you should be all right.

 

[Sir Peaches]

ok sweet, thank you soooo much for your help; you have really made me feel a lot better and more confident in my decision to go back to 6mp...i just hope the doctor feels the same way and doesnt tell me to go with humira. if there are any questions i should ask or things i should mention feel free to tell me. i dont really have any pain but i did feel food having trouble getting through where it had narrowed, although feeling better than ever since being on prednisone for almost 24 hours and no doubt 6mp will help me like it did before, the main issue is just the narrowing and stopping the inflamation. since 6mp and humira are both used for that i guess im gonna try and convince the doc on 6mp unless he suggests is first. thanks alot for the help

 

[theOcean]

No problem! And even if your doctor does lean towards Humira, just tell him you'd like to try out 6mp first and if that doesn't work out then you'll consider Humira. I'm sure he'd understand. It's your body, after all!

With Humira, there's a few things to ask about. If you're getting it in pen form or syringe form (I use the pre-loaded pen because I can't look at needles), and if you need to get the pen to be latex-free. Also ask if you'll be trained on how to use it the first time when you get your loading doses done, since that way you'll do the loading doses with a nurse. I've been on Humira since last November and I moderate the section on it, so if you have any questions I'm happy to answer them!

When the inflammation dissipates it should help with the narrowing a bit, but it does mean you have to watch out for obstructions in the future. You might want to familiarize yourself with some of the symptoms of obstructions just in case.

Good luck with everything.