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Biologic vs. Imuran


Mon, October 08, 2018 10:28 PM

My 18 y/o with Crohns is currently on Imuran (for 8mo. now), though at a level not quite high enough.  He's been on it since Dec, and has been having symptoms/inflamation showing on MRI and in blwk.  Dr. leaning toward biologic, but unsure if we should give Imuran a bit more time at an increased dose 1st?  I am worried to allow inflamation to continue, potentially causing damage, but unsure ready to jump to biologic.  Anyone have success with Imuran?  Or have opinion on this?  He was dx at age 10, and was steady for many years previous to Dec last year.

FPO jrichins
Joined Feb 10, 2018

Mon, January 14, 2019 10:45 PM

Reply posted for marck.

For Crohns, I have taken Imuran, as much as 175mg but now less, and a Biologic together, Humira didnt work for me but Remicade did.  Until I took both together nothing really worked other than prednisone which we all know is a poor long term solution. Hopefully your doctor finds the right mix. Don't be afraid to seek out the best local hospital specialist to confirm what course your Gastro doctor suggests. You are talking about a lifelong disease so more opinions never hurt.

FPO marck
Joined Jan 14, 2019

Fri, January 11, 2019 5:35 PM

Reply posted for Shar31.

Thank you:)  That does make me feel better about the biologic (Humira).  So far so good, as we started it.  Now we are just trying to fatten him up...his weight is a yoyo, and he's too skinny.  Hard to control a teens diet with their social lives!  Best of luck to you as well:)

FPO jrichins
Joined Feb 10, 2018

Fri, January 11, 2019 12:29 AM

Reply posted for jrichins.

I was hesitant to go to a biologic as well but was scheduled to start today (starting a post with my experience).  At one point, I took Imuran (azathioprine) for about 9 years and was flare-free, along with Asacol.  I often had sinus infections or would get a sore throat in the late afternoon which would disappear with some Tylenol and a night's sleep. These lessons when I stopped working in an office building and worked at home.   I stopped Imuran and remained flare-free for about 3 more years until the past year.
Now, I am back on azathioprine and mesalamine (Asacol) and finished prednisone recently.  I am adding a biologic after getting a second opinion. 

Due to a recent flare, I visited a doctor at Penn Medicine at their Inflammatory Bowel Disease center. He explained to me that prednisone and azathioprine are the two worst medicines, in terms of UC treatment side effects.  I respect his opinion since they do so much research there and are recognized globally.  
I was hesitant to move to a biologic, too, but I remind myself of what he said about side effects. Also, he said the risk of colon cancer due to severe inflammation is higher than the risk of cancer from a biologic.
Something to consider and discuss with your doctor.
Good luck.

FPO Shar31
Joined Jan 10, 2019

Thu, October 25, 2018 3:45 PM

Reply posted for haymikey.

Thank you for your responses:)

FPO jrichins
Joined Feb 10, 2018

Thu, October 25, 2018 2:15 PM

Reply posted for jrichins.

Imuran made me deathly ill.  I’m now considered allergic to it.  Remicade and entyvio I’ve been on  and both did nothing for me.  good luck. Everyone reacts differently.

FPO charbs
Joined Oct 31, 2016

Thu, October 25, 2018 12:36 AM

Reply posted for jrichins.

For what it's worth, I've been on Purinethol ( a slightly different molecular version of Imuran) for 30 years now... with 1 flare in 30 years.  Before giving up on Imuran you may ask the Dr. to do a 'Thioprine Metabolites' blood test to better determine what the optimum dosage may be for your son. He me need a higher dosage.  Most doctors seem to prescribe dosage by body weight alone... but each of us metabolizes Imuran differently, and some may require more... some less.  And for some, the drug simply will not work.  This was a miracle drug for the last 30 years.  I've been symptom free.  But now I'm concerned about toxicity to my bone marrow, and may need to switch to another medicine... but again, this was a blessing.  Good luck and God bless.

FPO haymikey
Joined Oct 25, 2018

Wed, October 17, 2018 9:11 AM

Reply posted for jrichins.

Just seeing if anyone had comments on my original post.  Dr. is feeling Imuran has more risks, and may not be a long term solution.  What are others experiences with Imuran and/or Biologics? 

FPO jrichins
Joined Feb 10, 2018

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