Starting Humira

[sisen]

I got to see my GI yesterday. Two weeks ago I had a flare up and had a small bowel obstruction. I'm being treated with prednisone and my 6-mp still currently. We talked about going on Humira and are going to get that ball rolling. I'm currently between jobs, my current health insurance lasts until the end of this month and I'm not sure when my new job will kick in its insurance. I'm trying to find out from them so we can get the ball rolling on obtaining Humira. I know it's going to be a rigamarole though.

My GI told me he's going to keep me on 6-MP and Humira together though. I had done research prior and know that there are risks and such. I felt confident with his opinion yesterday in the office. However, last night I got to reading the pamphlets and kit they gave me on Humira. I know 6-mp and humira both have a chance for cancer and other associated risks. It was really alarming and off putting to read how a majority of the cases were young adult males like myself who had either prior treatment with 6-mp or concurrently with humira.

Obviously there are going to be risks and there are also successes. It was just so alarming to read.

 

[24601]

I know it always makes for alarming reading but I believe the actual incidence of lymphomas due to 6mp and/or Humira is low and therefore the benefits usually far outweigh the risks.

The one group for whom there is particular concern though is, as you said, young males and I believe methotrexate is often used instead for that reason. This isn't something I have experience of myself but I know other forum members do so I hope if I give your post a bump that someone with more knowledge can advise.

I don't know if this will work but I'm tagging my little penguin to hopefully answer

Good luck! I hope you do well on Humira!

 

[my little penguin]

Ok breathe
The funny part about Ibd meds is they have to tell you the scary risks
But most docs are only going to prescribe a new to a patient when the benefits outweigh those risks
To put things in better prospective
I am a parent and my kiddo started biologics and had been on 6-mp prior to the ripe old age of 8.
Let's run the numbers

Risk of death in children under 14 ( above 14 your toast anyways by risky behavior)
By car

 

[my little penguin]

Risk by car 1 in 250
By drowning 1 in 1000
To get T cell lymphoma for non Ibd person walking on the street 2 in 10000
Risk for Ibd person who at one point took both meds 6 in 10000

Taking infant tylenol can kill you ( steven Johnson syndrome ) pediatricians don't talk about that one
As can any benign med antibiotics any one pencillan has similar risks of SJS .

Leaving inflammation to simmer gives you a higher risk of lymphoma just from having untreated or under treated Ibd - same goes for arthritis so my kid has a double whammy.

Just know the docs monitor it much closer than if you were taking tylenol and there are some reports that the risk is lower in the combo of Mtx plus biologics
Since Mtx has a lower Lymphoma risk in general.

Also know that it's not just young males the more they look ( again risk is small so it takes a long time to identify the groups ) tgey more other groups are also showing up in terms of age and gender .

I let my kid ride in a car each day
Improves quaility of life which is much riskier than any Ibd med especially as he will soon be a teen and at that point meds risks are the least of his concern in terms of survival

Tagging Maya jmrogers crohnsinct clash and tesscom
All parents who have taken the "risk" and are enjoying the benefits

Good luck

 

[my little penguin]

http://www.crohnsforum.com/showthread.php?p=866472#post866472

Thread on Mtx and cancer

 

[crohnsinct]

Yep! Took the risk. I had to. My daughter came face to face with the risk of untreated or undertreated disease and nearly lost her life. So I grabbed that Remicade with both hands and pray everyday that it keeps working and we never have to leave it. The funny thing is, our infusion center is an hour and half away. Three hour round trip drive. The biggest risk with Remicade is the car ride to the infusion center!

Since dx my daughter has grown 8 inches and gained 40 pounds...in 2 1/2 years...and not one flare or increased illnesses! She also added Methotrexate about a year in.

So when my younger daughter was dx'd I was ready to take that biologic leap but doc said Methotrexate alone. I am way more scared of Mtx and the liver risks than I am of any cancer risks.

I know the risks of cancer with 6mp or Imuran etc are there no matter when you took or stopped them but if it helps you feel better why don't you ask about switching the 6mp to Methotrexate and adding the Humira. It does take Methotrexate some time to become therapeutic so you will have to come up with a bridge plan but I have been reading some encouraging information about Methotrexate and would be inclined to ask about it especially if I had a young male son.

 

[Maya142]

This is a great presentation that talks about the risks and benefits of IBD meds. The risks are scary, but for us, untreated Crohn's was scarier.

http://programs.rmei.com/CCFA139VL/

My husband and I agonized about putting our daughters on biologics and then they turned out to be the best thing for both of them. Then we agonized about adding immunomodulators (MTX/Imuran) and those also made a huge difference. Neither has every had any side effects to biologics (no increase in infections) and no real issues with combination therapy (some nausea with MTX for the older one, nausea that went away after a few days with Imuran for the younger one). In terms of quality of life, these drugs make all the difference in the world.

Good luck!