Side effects?

[Lam123]

How rare or common are side effects like lymphoma in taking Imuran?

 

[DJW]

Hi. I can't give you exact numbers. My GI specialist felt it was a lot less than the serious crohns complication I've had (toxic mega colon, bleeding out, strictures, abscesses, fistulas, and multiple perforations).

 

[hawkeye]

I think I read somewhere the rates are in the range of 2:10000 or 4:10000

 

[Patricia56]

Here is a 45 page article that attempts to answer your question.

http://cdn.intechopen.com/pdfs-wm/35455.pdf

To grossly simplify the results, the normal risk for Non-hodgkins lymphoma in the US is 20 cases per 100,000. The risk for lymphoma of all types is increased by about 4 fold in IBD patients on AZA/Mercaptopurine. So that would be 80 cases/100,000.

What you should actually be worrying about is skin cancer. This is turning out to be a much greater concern.

Also apparently the risk for lymphoma is greater for smokers than for people with IBD who use these drugs (see the article).

 

[LindaS]

What you should actually be worrying about is skin cancer. This is turning out to be a much greater concern.

I had never heard about skin cancer being a side effect of Imuran. Is that a new thing? I've been on it off and on most of my time with Crohn's, which is over 25 years.

 

[GreenwichUK]

The guidance now tells you to avoid the sun and use high SPF so that makes sense

 

[Lam123]

I always use sunscreen of about 50, so that's good!

 

[Patricia56]

Yes there have been several large population studies which have shown that there is a risk of skin cancer associated with the use of AZA/6-MP. I don't know about other immune suppressing meds. There aren't as many people taking MTX for them to be able to do risk calculations probably. And most recent study of Remicade suggested there is no increased cancer risk at all.