Symptom free but starting Humira...

[mamalana]

Hi all! I have been taking Imuran for about two months now and currently have no symptoms other than occasional mild cramping and constant anemia. My GI prescribed Remicade originally which the insurance denied. He then moved to Humira and it was approved- I start Monday.

My question is, if I am currently doing ok on Imuran alone, should I still start the Humira simply because it took so long to get approval? I'm afraid if I hold off that my insurance may deny it in the future.

Has anyone dealt with a situation similar? Any advice is appreciated.

 

[InkyStinky]

Hi! Do you still have a lot of inflammation going on? IBD can be active and causing inflammation even if you have no symptoms.

Has your GI recently checked labs? Some that can show inflammation are WBC, C-Reactive Protein, ESR (sed rate). Had any scopes recently?

"Combo therapy" (immunosuppressant + biologic) is what my GI typically uses. Is your GI wanting you on both Imuran and Humira at the same, or is the Humira supposed to replace the Imuran?

 

[mamalana]

Hi!

Yes, I have had labs and scopes, all within the last two months or so. Yes, he is wanting the combo therapy, and I honestly didn't even remember about my markers being elevated until you mentioned it, lol...NOW the addition of Humira makes sense!

 

[InkyStinky]

There are so many facets to these dang diseases, aren't there?! Hope that med combo works well for you!

 

[Lady Organic]

you have the option to wait and have another scope, biopsies and blood tests soon to validate the complete work of Imuran. When is your next scope planned? Imuran can take a few months to be fully effective and i dont know what your dosage is, but often GI start with lowest dose. back in 2002, I started on purinethol at lowest initial dose and 4 months later, we had to increase it to maximum dose because I was slowly relapsing. The highest dose kept me in perfect remission for 7 years. If you already notice a good improuvement with Imuran, that is awesome and it could be paying to wait a few more weeks or months and see if it can bring you in remission as a monotherapy. ask your GI about it. My first GI was all about minimizing therapeutics. Drs all have their personality styles and opinions. Each case is also different. my idea regarding insurance, is that your GI will most likely work it out for you if you come to need Humira now or later. It may possible to put it on hold? Insurance companies prefer we try other treatments before such as Imuran. If the immuno-suppressant fails, Biologics companies are more open to cover patients afterwards.

 

[Robrich]

I agree with lady O, if you are not showing inflammation.
None of these drugs work forever and they all come with side effects.
We're in this for the long haul and eventually many of us find ourselves with no more medical options, so having Humira on deck is very comforting.
We also can build tolerances to the meds and after failing biologics one might find the disease even harder to control.
Healthy diet and lifestyles often augment the efficacy of the meds. Find what works for you and don't count on your Doc for much help with that. Most docs don't go there except in very general ways.

 

[mamalana]

I have spoken with doc and he would like for me to go ahead and start with the Humira because my markers are still showing inflammation- it's down some, but not enough. I mentioned the lack of side effects and just as mentioned by several of you, he said everyone is different in the way they present symptoms. He ran through a list of symptoms that are not painful, and my increasing anemia (I'm down to 9.2 now), extreme exhaustion, and lack of regular bm pattern are my symptoms and I simply did not realize that Crohn's could cause them (anemia, yes, but the exhaustion?!). He did state that as soon as he sees signs of remission via lab work, we will start tapering the Imuran down and weaning to see if the Humira alone will work.

 

[DougUte]

If you still have elevated inflammation markers then I would think that the combo therapy would be advised. Sounds like you and your GI have a plan in place.

I have been on Humira for 4 years and have been in a long remission. It is a good med and I hope it works for you.

 

[Sunshine333]

I have been taking Imuran for the past 7 years, but colonoscopy still show ulceration and strictures. I have been delaying using Humira since my Crohn's seems to be in remission or much less active. However, I start to realize that ulceration needs to be controlled and strictures causing bowel obstruction can be a significant health issue. I will start using Humira this week and I hope this super expensive med will do what it suppose to do, keep my bowel in good shape.