I suppose Crohns is so difficult because everyone is different* . There are people on this forum that have been years on AZA or 6mp without issues or secret damage happening. I think ultimately, in my personal opinion, what anyone with Crohns should do is:
1. Find a GI that you like and trust. This disease is too serious to keep a GI that you feel meh about around.
2. Discuss your particular case/prognosis with your GI. Crohns is very different in different people.
3. With the information from 2, discuss treatment options. I personally feel that the best doctors are the ones that explain all your options to you, makes a recommendation, but ultimately is willing to do what *you* think is best for you.
4. Make a treatment plan with your GI.
5. Follow up! I do believe that even if you start at the middle of the treatment pyramid (ie with AZA or 6mp), if you are closely monitored by scopes (not just blood work!) on a regular basis, you will be able to quickly up your treatment if your current one is not leading to mucosal healing. The goal is to reach endoscopic remission, of course.
Anyway, I'm by *no means* suggesting that starting with Remicade is the wrong decision. I'm sorry if it came off like that. I think it's ultimately a personal decision that needs to be made with risks/benefits in mind. I hope the links posted above helped you understand a little bit more about the risk/benefits of each treatment option and disease progression.
Good luck and keep us posted!
*My personal, speculative opinion is that we'll some day discover that what we call Crohns today is more than one condition. Likewise, I feel that treatment/follow-up strategies should be as personalised as possible since this disease is so different for different people.