6 MP + Prednisone OR Remicade? HELP!

[CrohnsPatient001]

Hello,

To make a very long story short (hopefully when i get more time i can write everything in more detail) I am faced with a choice. Tomorrow I will be having a half colonoscope (not sure of the terminolgy but basically I will be having two fleet enema's then with some camera my doctor will look into my anus (just a little bit in). The reason for this is because for some time now I have had rectal bleeding. She says If she finds that my chrons in my anus is active (which I believe it is due to almost regular bleeding...) then i am faced with two choices, either 6 MP + High dose of Prednisone OR Remicade. I have had previous prednisone a few months ago however i had a bad acne reaction... Even so I am unsure which to decide... So I am curious if you where faced with this sitation which would you choose? Thank You!

 

[Ilysha]

I'd choose the Remicade. No question. I've been on it for 4 years and I think it is a wonder drug!

 

[Kev]

Hello CP001... The pred isn't a long term solution. you'll have to taper off of it eventually. As for the 6 MP Vs the Remicade, I haven't had either (yet) so I'm not in a position to advise; and keep in mind that we here are not doctors, just people with the same illness who share their experiences. My understanding of 6 MP is that it is similar to Imuran/azathioprine, except for how it makes its way into the system.. I was given a choice between Imuran and Remicade, and in my case, I opted to try the Imuran. Part of the reason was the history... It's been around for a while, and has had good results. A secondary reason was the cost, I have no health insurance, and the cost of Remicade infusion can be very daunting. does your insurance cover it? If you are covered, and cost is not a factor, then ask your GI/Dr for the history of each, their respective results, and of course the long term side effects, ok?

Anyway, welcome to the forum...

 

[CrohnsPatient001]

Hello again,

Thank you both for your suggestions. My appointment was canceled due to several complications but I will be meeting with my doctor this thursday. On the date I will try and discuss with him my alternatives. Thanks!

 

[Kev]

You may also want to raise with your doc the pros & cons of remicade vs humira

 

[shoe_fanatic708]

Remicade definitely is a wonder drug!! Prediscone and 6-mp...mm..their ok lol. I was on them at one time or another in the past, but am now taking a mixture of remicade and methotrexate and its working fairly well. So I would definitely choose the Remicade if I were you :]

 

[PhantomX]

I've been wondering if anyone that has been consistent with their Remicade treatments has come out of remission, or catches a lot of other bugs due to the immunosuppressant effects of the drug. Also wondering if anyone that is not on any drugs or has tapered them off has stayed in remission for lengthy periods of time... I'm sort of reluctant to pump my body with stuff for prolonged periods of time.

 

[Kev]

Hey Phantom.. the following is all subjective, based partly on my own history, and anecdotal or otherwise absorbed info in this garbage bin thing I call my brain
(as in trash in, trash out, and a very shakey filing system & retrieval method, OK).. I don't know what your medical history was like pre IBD, but in retrospect I seemed to catch everything under the sun as a child.. all the typical childhood illnesses AND then some. measles, mumps, chickenpox, german measles, scarlet fever, whooping cough, the list just went on & on. I also, as an adult, had it pretty rough.. a flu so bad I was hospitalized from dehydration, then kidney stones from dehydration.. I even caught hepatitis.
Then, when raising my kids, seemed like I was always getting some form of stomach flu (which doc's now think was actually early issues with crohns). My point? I'm not sure whether IBD is due to overactive or underactive immune system. I think the experts aren't too sure either. Oddly enuff, after I was diagnosed AND put on various and sundry types of meds, I haven't caught any bad bugs with the frequency that I had pre-meds. Real odd puzzle. So I personally dont' fret about catching new things while on these drugs except when I go to a hospital or clinic (all kinds of sick people hang out there). You need to look back on your medical history, see if there are unexplained events in your past, try to put them in perspective. Then again, the past is past.

As for remaining in remission after coming off meds, I vaguely recall reading a stat that 4 out of 5 patients suffered a relapse of some sort afterwards. My feeble memory doesn't recall whether the relapse was significant, long term, short term, etc.. I also recall one of my first GI's telling me the drug therapy I was on only had about a 20% chance of success long term. I wasn't crazy about those odds when I first heard them, still not keen on them over time.

 

[shoe_fanatic708]

With the Remicade my immune system is extremely low, and I catch pretty much anything that I come in contact with. And if I do catch something, it takes longer to fight it off.

I was in remission for a while with the Remicade, but my Doctors tried to further the infusions - from once every 6 weeks to once every 8 weeks, and so on, and I came out of remission once again.

Its a great drug, but there are a few chances you have to take. Just weigh the pros and cons with your doctor and family.

 

[Ilysha]

Actually since I've been on Remicade (4 years now, with a 10 month break in the middle) my immune system seems stronger. I rarely get colds. I think I've had 2 in the last four years, and no flu. I think I am healthier and feel better overall which helps me not get everything in sight.

I know this is not the norm, but thought I'd share. Maybe your immune system will act similarly.

 

[Kev]

Hmm, food for thought. I was just reading another thread, where someone had speculated that there might be two distinctive forms of crohns (which would help explain why 'one' disease commonly affects so many people so differently).
My gut reaction was no, but everyone knows how bad my gut is. Perhaps if we look at it as a swinging scale... overactive immune system on one side, normal immune system top dead center, and underactive immune system on the other. The fortunate ones, with their normal immune system, are A-OK, till the scale swings and sticks in one direction or the other. that may explain why some scientists think IBD is overactive immuno related, while others say its a weak immuno response at fault. Sort of sounds like goldilocks & bears..

 

[katiesue1506]

I'd choose Remicade as well. It threw me into remission... I was on Imuran and Prednisone at one point and it just kinda covered up my problems. I felt a little better, and I was eating more... a LOT more, but I wasn't getting better. Remicade allowed me to eat whatever I wanted (with the exception of Italian Subs and Taco Bell in the same day)

But it is ultimately a personal choice... I know I was super scared to start the Remicade, but the benefits it provided me made every worry go away.