To combo or not to combo?

[MirrorBride]

:sign0085:

I need advice, please!

I have moderate terminal ileum Crohn's, and I've been on weekly Humira for about 3.5-4 months, feeling better (I used to be throwing up and physically very fatigued) but still experiencing some symptoms, like stomach gurgles, cramping, loose stools, gas, and diarrhea once or twice a week (weirdly, the diarrhea didn't begin until after I started Humira). I'm also on a prednisone taper, currently stalled at 10mg.

So here's the issue: My GI recommended that I add 6mp to help, but I'm very reluctant to take it for a few reasons...

First, the risk of cancers increase with combination therapy, and this is something that freaks me out. I know the percentage is still low, but I also experience anxiety, and of course, I'm convinced I would be one of the unfortunate ones.

Second, I am very sensitive to medication that have a side effect of nausea, and would almost certainly be throwing up with 6mp.

I asked my GI if there were any other alternatives, and she said the next step would be to go to Remicade if I didn't want to take 6mp.

I'm just wondering what you all have done/would do in this situation, and if you had any advice and/or recommendations for me.

Thanks!

 

[Mr chicken]

DS is on combo ... He is 11.
I know you know the risks are small but Mtx and humira has an even lower risk .
So the numbers that help me as a parent sleep at night
Risk of death for kids under 14
By car 1 in 250
Drowning 1 in 1000
T cell lymphoma for average person on the street who doesn't have Ibd 2 in 10000

Taking a combo of humira plus 6-mp 6 in 10000

Numbers are not known for combo of Mtx plus humira

If you got Mtx route make sure to get folate with the Mtx it gets rid of any side effects .

Good luck

 

[Lady Organic]

at 22 if you plan on having children soon, methotrexate would not be possible. but if not and if you can reassure your GI about no chance of conception, methotrexate is getting increase in popularity for combo, bust as mentionned above, research is still lacking i believe.
adding 6-mp to current humira seems a better idea to me than switching to remicade. Even at minimal start dose, (50mg) 6-mp is a therapeutic dose and can keep some patients fully in remission, alone as a treatment. I am currently only on 50mg 6-mp and hoping to keep in remission. As for remicade, there is no certainty it will be working if you switch and you'd risk getting back to square one, or also in the same situation as right now, having to add 6-mp to it. combo therapy is used with remicade too.

concerning nausea on 6-mp, it is usually very mild and lasts just a few weeks at introduction.