Humira and TB

[Floridaframer]

I am a 54 year old male and was diagnosed with Crohn's 18yrs ago. I have been having trouble stay in remissions on oral meds. Currently on the taper down with Prednisone. This is not my first round with what I call the nasty stuff. I have a meeting with my GI doctor on Wednesday to discuss other options one being Imuran the other Humira. I have previously been on Imuran and at one point it elevated my liver function to a point that there was concern so they took me of it. The kicker with the Humira is that at one point we were looking at Remicade so they had me take a TB test. It came back boarder line. The had me go through the 9 month treatment of antibiotics. I have not been retested. My internist is totally against Imuran and says that the TB results my have been a false positive. Anyone have this issue???

 

[David]

It's possible it was a false positive. How about a retest?

Welcome to the community by the way!

 

[Floridaframer]

I am going ask my Internest to do a retest. I saw my Gastro Doctor on Wednesday. He had spoken with others in the field. All of them felt it was not worth the risks. Also in Duval county in Florida where I live when have had an outbreak of TB that had been kept under wraps. They have put me back on Imuran. I had a increase in liver function once before while on it but was also on Lipitor so we are not 100% sure it was the Imuran. We are going to monitor Liver functions and see what happens. The doctor said that there is a drug that is used for treating certain forms of Leukemia that a colleague at University of Chicago Medical has been using with great success. Problem is FDA approved for Leukemia only right now. If liver functions go haywire going to partition insurance company to cover.

 

[David]

Best of luck on the Imuran and with the retest. Please keep us updated And keep the TB in your county please, we have enough issues here in Collier

 

[Floridaframer]

My gatro totally ruled out Humira and Remicade. Says to high a risk. Have been doing blood work on a regular bases. We have seen my toxicity levels climb while on the Imuran while the therapeutic levels have not. He has suggested that we try 6-Thioquanine (Lanvis). This is a drug used for treating Leukemia. It is not approved for Crohn's, but they have been having great success with it. The really trick is what it will cost. Will know tomorrow.

 

[ron50]

My wife was put on humira. Prior to starting she had blood tests for TB anti-bodies . It came back positive so she had to do six months on an old anti-biot originally used for leprosy, She was prescribed humira for severe psoriatic arthritis and psoriasis. It has given her a hard time. She grew up in central Australia and has major skin ca problems. Humira has added to that problem and nearly killed her when they used fudex on her cancer. Apparently humira and Fudex should never be used togeather. She was really ill with 5fu poisoning. (Fudex is a cream made from the chemo agent 5 flourouricil)

 

[David]

Interesting perspective that your GI has. Here are a few studies/papers on 6-thioguanine if you're interested:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3111675/
http://www.ncbi.nlm.nih.gov/pubmed/18521912
http://www.ncbi.nlm.nih.gov/pubmed/12622758