Medication question

[Lam123]

What is the difference between imuran and methotrexate?

 

[my little penguin]

In terms of ???
Mtx has a lower lymphoma risk vs imuran
Both can hurt the liver
Neither is good for sun exposure
Both increase risk of basal cellcarinoma
(But so does ibd )

Ds has been on mtx with humira for 4 years
Mtx helps joints more for arthritis vs imuran
The kiddie GI no longer give biologics plus imuran due to
Increased T cell lymphoma rate
And use mtx instead

Very High level of birth defects with mtx compared to imuran

 

[Lam123]

Thank you! I have taken humira with imuran in the past, currently on humira, but methotrexate might be added for joints.

 

[Lam123]

What about hair loss? Is one worse then the other. On imuran my hair thinned out a bit, but was manageable.

 

[ronroush7]

What about hair loss? Is one worse then the other. On imuran my hair thinned out a bit, but was manageable.

Same here.

 

[Lam123]

Same here.

Did you take methotrexate? Did it help at all for joints?

 

[ronroush7]

I have asked about that medication but with my history I think my doctor is scared to try. I have had reactions to remicade, flagyl and doxycycline.

 

[Lam123]

Oh ok. I was on imuran for about 10 years and didn't have any issues. But it stopped working, so now I'm on humira. I'm having some joint issues, not sure if the crohns is active again or are the joints acting up on their own.

 

[ronroush7]

I think but not.sure there is some commection between crohn"s disease and arthritis. I have minor arthritis in my lower back

 

[Lam123]

I think but not.sure there is some commection between crohn"s disease and arthritis. I have minor arthritis in my lower back

What do you do for your lower back?

 

[ronroush7]

I see a chiropractor. I have wondered if there was something I could take for my lower back.

 

[Scipio]

Chemically the difference between the two that Imuran is a purine analog, meaning that it is similar to but not the same as some of the four bases, sort of building blocks, that make up DNA. So it interferes with some enzymes involved in nucleic acid chemistry and cell division.

Methotrexate is a folate analog, meaning that it is similar to but not the same as the vitamin folic acid. So its action is to interfere with the action of enzymes that use folate as a co-factor.

So both of them act to slow down the immune system by slowing down some of the enzymes and processes involved in immune activation and cell division. But since, as you can see, they act in different ways and on different enzymes and processes, their side effects and how well they work are not quite the same.

Hope this helps.

 

[Lam123]

Thank you!

 

[my little penguin]

Methotrexate is commonly used by rheumo for peripheral joints
But doesn't have a lot of success in axial joints (i.e. Spine or lower back )

Biologics are needed for axial joints

Tagging Maya142

 

[Maya142]

My older daughter is currently on MTX. She does not have hair loss as a side effect. She has mild nausea and fatigue the day after the MTX shot (she does it on Friday nights, so she can rest the next day), but no other side effects. She takes folic acid daily and that helps with side effects. She is also allowed to take Zofran for nausea if necessary.

MTX works well for the peripheral joints - such as the knees, hands, elbows, ankles etc. It is a good option if you have arthritis in those joints.

If the spine or SI joints are involved, a biologic is usually used. Since you're already on Humira, if those joints are involved, they may either up your dose or switch your biologic.

Are you seeing a rheumatologist? Spondyloarthritis is associated with Crohn's and needs to be treated by a rheumatologist.

Ron, just FYI, a chiropractor is not recommended if you have SpA - they can cause a lot of damage. You didn't say what type of arthritis you had - osteoarthritis is also very common in the lower back - but I figured I'd tell you.

 

[Lam123]

My older daughter is currently on MTX. She does not have hair loss as a side effect. She has mild nausea and fatigue the day after the MTX shot (she does it on Friday nights, so she can rest the next day), but no other side effects. She takes folic acid daily and that helps with side effects. She is also allowed to take Zofran for nausea if necessary.

MTX works well for the peripheral joints - such as the knees, hands, elbows, ankles etc. It is a good option if you have arthritis in those joints.

If the spine or SI joints are involved, a biologic is usually used. Since you're already on Humira, if those joints are involved, they may either up your dose or switch your biologic.

Are you seeing a rheumatologist? Spondyloarthritis is associated with Crohn's and needs to be treated by a rheumatologist.

Ron, just FYI, a chiropractor is not recommended if you have SpA - they can cause a lot of damage. You didn't say what type of arthritis you had - osteoarthritis is also very common in the lower back - but I figured I'd tell you.

It's mainly my knees. I actually think I'm in a mild flare, bowel movements are looser then normal and I'm having a few more then usual, mild stomach cramps. So hopefully with some extra rest and careful eating I can get back on track. If I don't see any change in a few weeks then I will see a rheumatologist. Thanks!