Change in treatment plan

[DanielleinMN]

I started azathioprine 6 months ago (on budesonide for the first 3 months). Due to the fact that my symptoms still have not resolved, though they have slightly improved, I had a follow up MRI yesterday. The nurse called today to tell me that there is still inflammation and that I need to schedule an appointment to discuss a change in my treatment plan. What's typically prescribed if azathioprine doesn't work? Someone please tell me something other than Humira or Remicade...I do not want to start IV therapy if there's another option.

If one of the biologics is what you ended up needing to do after azathioprine, how long were you on it and how often did you need treatment? Were you able to get off it and switch back to azathioprine after your Crohn's was in remission?

 

[theOcean]

Humira is administered by injection, and Remicade is by IV. If the immunosuppressants like Azathioprine don't work, unfortunately they are most likely going to try you on a biologic. Most of them are injected, but they often have pre-loaded pen options (like an epi-pen) which aren't so bad. Out of them, Cimzia I hear doesn't hurt very much either, and is less likely to cause reactions. It's also only given once a month.

I was on Imuran for a few months following a very severe flare and discovery of a fistula. I was actually on Remicade already before going on Imuran, stopped Remicade due to allergies, and then went on Humira last November. It's been treating me incredibly well.

Humira is one of the biologics that you're able to stop and potentially go back on later, whereas with Remicade once you've tried it and stopped, you're not able to go back on it again. If you really want to stop, you can, but that increases your likelihood of getting a flare and decreases the potential remission time you will experience.

It's also said that the younger you introduce biologics to your system, the more likely it will be that your illness will be milder later on.