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Humira as first therapy

My son was diagnosed 3 weeks ago. He has responded well to antibiotics and Budesonide. Pain gone and he is eating well on low residue diet. As his first treatment the GI wants to start him on Humira. Some people tell me to wait and use it as a last resort others say they have been on Humira for years and are doing fine. I'm worried about pushing too hard about trying something else rather than going right to Humira in fear of being wrong and advising against what the GI wants to do. It seems so extreme. Have others here went right to Humira as first treatment and how did it go?
Hi. I am not sure of the answer to your question. I guess it would depend on how severe your son's disease is. I am going to tag Clash, Maya 142, my little penguin. At some point, you might want to check out the section in here called Parents of Kids with IBD. I wish you guys the best.


Staff member
Hi and welcome! How old is your son? Be sure to check out the parents forum.

The thinking has actually changed - many GIs are using the "top down" treatment method. They use more effective drugs like Humira or Remicade first to get the disease under control. The idea is that this will prevent long term complications like strictures, abscesses, fistulae etc. It will also help a child heal enough so that they can grow and gain weight properly. Studies show using biologics early in the disease prevents surgeries in the future.

It also generally reduces the amount of time kids are on steroids, which can have all sorts of awful side effects. Budesonide is a steroid and though generally kids have fewer side effects than on Prednisone, over time they WILL develop side effects.

New drugs are in the pipeline and kids can be on biologics for years, so I wouldn't worry too much about options in the future.

In some places, the step up therapy is still used. With that method, they use meds like 6MP or Azathioprine first and then wait and see if they work. If they don't then they go up to biologics. This method can take a lot longer and so complications can develop.

We used Remicade and MTX first for my daughter. Within 8 months, her scopes were MUCH improved. All the ulcers in her colon had healed and it looked "beautiful." She had mild inflammation left in her TI but that's it. It was remarkably successful for her.

Good luck!
I asked my GI also why Humira first.....she stated she wanted to try the top down approach as I had already 5 crohns related bowel surgeries! AND I've been in remission for 3 years since starting the Humira! I also went on Budesonide prior to starting Humira.....then weened off the Budesonide!!!! Good luck!
My daughter has been taking Humira since the age of 4. It still helps her. She is 6 now.
It was a scary/tough decision, but in hindsight it has helped greatly.