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I'm very far from an expert on this, but I believe that Methotrexate is often used instead of 6MP, in addition to other medications.  My daughter is currently on Remicade which is helping, but not getting rid of a stubborn fistula/abscess she has.  Her doc is starting the 6mp to hopefully give her the boost she needs to get past this.  I believe I've read that they use Methotrexate in the same way.  Hope that helps