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Difference in treatments?

My son is 9 and is on EEN and has just started 6mp, I wanted to know the difference in treatment options.....such as why some children are prescribed Remicade and others Imuran.....do they all do the same thing??

Inducing remission, healing and removing inflamation etc, I'm so confused lol


Staff member
You know I tried answering this a few days ago and had no real luck in explaining anything so I wound up not posting and then forgot to get back to it later. D: Bad me! I know 6MP is an immune suppressant and I personally did really well on it for many years. Took it both before and after my resection. Imuran is in the same class of meds as 6MP. I believe (if I explain this right) Remicade and Humira are classes of meds that help prevent inflammation from occurring.

As for why one is prescribed Remicade and another 6MP, it has to do with the severity and as I noticed David puts it, a lot of doctors (but not every doctor) use the "top down" approach where they use the strongest meds possible to help induce remission quickly and this method has shown much success.

I don't think that was all the info you were looking for but hopefully someone else will be able to stop in and give a more lengthy response. :)


Super Moderator
I think the answer to that farmerswifey boils down to two things...your GI's beliefs and preferences and your geographical location.

Many doctors now believe in the top down approach which is hit it hard and fast and in doing so limit the damage done. Rather than step up which escalates as each treatment fails and all the while inflammation remains under treated.

Then there is geographical location...

This becomes apparent in initial treatment. For children EEN is frequently used as a first line treatment in most western countries aside from the US.

This then moves to the next step of treatment. Most, if not all, western countries aside from the US have universal health care. It means our treatments are 'free' but with that comes a set of strict guidelines at which point a person can access the more expensive treatments. It often means failing certain medications before you are approved for things like Remicade, so much like a step up approach.
You will find under Medicare that the guidelines for children are not as strict as they are for adults as are certain types of Crohn's or severity of disease, e.g. severe refractory disease and/or fistulising.

The aim of medication once past initial treatment, steroids and EEN, are to continue the process of inducing remission and then maintain it. The differences in the classes of drugs...5ASA's, immunosuppressants and biologics...is the way they are designed to action that task in the body.

Dusty. xxx