Maintenance Therapies...Help

[fenway1971]

I'm weaning off Prednisone (yay!) and should be off by year-end. Good riddance as I hate the side effects.

Anyways, I'm thinking I may be one of the 5-15% out there who doesn't tolerate Colazal or Asacol well. Reason I say that is I was on high doses (12 pills/day) along with Prednisone and saw modest improvement. Last week, I decided to stop taking Colazal and my symptoms improved and I'm pooing nearly flawlessly now. This was noticeable a day after stopping the colazal.

Not sure how to prove whether I'm allergic or not to the drug, but I just have a hunch about it.

So....what other options are out there that I should discuss with my GI. See him next week.

Thanks!

 

[Colt]

Well if you can't do 5-ASAs you're stuck going up to the next level which is immuno-suppressants. 6-MP or Azathioprine. They inhibit T-cells (same thing HIV destroys) and reduce the activity of natural killer cells. Those are types of white (immune) cells. The potential side-effects are stronger (you are directly reducing your immune system after all) and it's generally a more powerful way to go than the simple NSAID 5-ASAs, but if 5-ASAs aren't an option then it's still not as bad as being on prednisone.

6-MP/Azathioprine have been shown to successfully replace prednisone for maintainence therapy in 70% of cases and usually takes 2-3 months to be effective. Time that out with your taper schedule and you should do just fine.

Things like remicade and humira are probably serious overkill if you were on 5-ASAs.