Where is science holding: Remicade only or with Imuran/6-mp?

[Sudsy]

We have friends who have a newly-diagnosed 6 y/o. The GI doc wants to start him on Remicade along with either Imuran or 6 MP, and says that this will help prevent antibody formation to the Remicade. Anyone know what the current scientific thinking re this is?

 

[my little penguin]

Ourgi will no longer use the two together
Neither will rheumo for that matter
They don't like the T cell lymphoma risk associated with the combo
They will use mtx plus biologics since that is not associated with a T cell lymphoma risk


Ds was dx at age 7
And was on remicade only -had a reaction
Placed on humiraonly
Later added mtx
Now on Stelara plus mtx

Good luck

 

[Maya142]

Our GI does not like using Remicade with 6MP either. Says the risks of malignancy are higher than with MTX. She will use Imuran/6MP with other biologics if absolutely necessary (for example, my daughter cannot tolerate MTX) and by itself but MTX is the preferred medication now.

Generally MTX is used at lower doses to prevent antibodies, and while at higher doses it is also therapeutic.

This is at one of the big pediatric IBD centers in the US.