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6MP/Imuran for joint pains?

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Posted 6/8/2009 1:19 AM (GMT 0)
Hi everyone,

My primary complaint regarding Crohn's right now is joint pain/swelling. I am wondering if any of you suffered this malady and found success remedying it (along with other symptoms or not) with Imuran/6MP. I'm trying to avoid Imuran and Remicade as long as possible, but need to get my ducks in a row in case it progresses to a point that I can no longer take it.

I would actually appreciate any and all experiences with 6MP/Imuran - even better if they include addressing joint pain.

Thanks!

Posted 6/8/2009 2:39 AM (GMT 0)
If you are having joint pain with swelling, I would recommend a consult with a rheumatologist. They are best at evaluating the cause and recommending a treatment plan to deal with it. Imuran is sometimes prescribed to control flares of lupus which include lots of joint issues, while in Crohn's Imuran is given to control the inflammation in the gut. Therefore, I think you should be properly evaluated. Good luck - I know how painful and restrictive the joint issues can be. My joints are my major issue.
Posted 6/8/2009 2:44 AM (GMT 0)
So what are you doing to manage the joint pains? You do have lupus? I'm so sorry for all that is happening to everyone here.
Posted 6/8/2009 2:44 AM (GMT 0)
My ANA tests have been negative, by the way.
Posted 6/8/2009 12:52 PM (GMT 0)
I have a lot of joint pain that my Rhuemy feels is from the CD. He tried giving me all the standard arthritis type meds, but they just did a number on my gut. My CD is basically stable on the meds I am on, so my GI won't change those meds, but my Rhuemy thinks that Remicade or maybe one of the other biologics would help my joints a great deal. He's just not willing to be the one to RX them given the fact that I can still function with my joint pain and my CD is "under control". So I was using acupuncture for my joints. It works pretty well, isn't a chemical that you put in your body, and forces you to stop and rest for an hour or so. The cost is can be a bit much, but I found a clinic where it was reasonable.

But the main thing I want to tell you is that my joint pain started about 6 years ago. I have been on 6MP for over a decade. My dose has been increased a few times to see if it would help with CD symptoms, but it never made a difference with the joint pain. Theoretically, if your joint pain is all from your CD, then it would stand to reason that getting your CD under control would make your joint pain go away too. But it just hasn't worked that way for me.
Posted 6/8/2009 1:13 PM (GMT 0)

From the uc forum, but just wanted to add that sulfasalazine has almost eliminated my uc-related joint pain.  It took about eight or nine months to notice the full effect, but I'm often surprised at how well it works.  Now, if it would only control the uc. . . .

Posted 6/8/2009 4:14 PM (GMT 0)
jhicks, 6mp didn't seem to do anything to help my joint pain and that is also my biggest complaint.  Also tried sulfasalazine for 4 months and had to stop it due to elevated liver enzymes.  It didn't seem to be doing anything either.  Trying methotrexate now (this is all in addition to Humira).  None of the regular arthritis drugs did anything other than hurt my stomach. 

Posted 6/8/2009 10:03 PM (GMT 0)
Joint pain is not usually a major issue for me, but I do get minor joint pain (and stiffness) with flares. I just started aza/Imuran about 5 weeks ago, so other people's experiences may be more informative than mine. But I am definitely feeling better overall (joints included) than before I started it. I completely understand your hesitancy about going on an immunosuppresant and I put it off for basically as long as I could. However, I am very glad that I decided to try it, because it seems to be working well for me with very limited side effects, and I actually wish I hadn't put it off for so long. I was very worried about the potential side effects (particularly long-term) of trying immunosuppression, but I eventually realized that the risk would be worth it to me if it meant that I would be able get my Crohn's symptoms under control enough to be able to live a relatively normal, happy life. I'm already noticing a big improvement in my quality of life and my GI just told me she thinks I'm on my way to remission.

I'm not saying these drugs (Imuran/6mp) are for everyone or that you shouldn't try other things before resorting to them. I just wanted to give you my experience and suggest that if the joint pain is having a major impact on your quality of life, you weigh the potential risks/side effects against the potential benefits of the medication, rather than thinking of it as something you'll try to avoid for as long as you can. Also, essentially all of the side effects from short-term immunosuppression are reversible, so there's little risk in trying Imuran/6MP for several months or so (assuming your doctor is getting frequent blood tests to monitor for potential problems) and seeing how you respond. You may already know this, but Imuran is actually approved on-label to treat rheumatoid arthritis, so it could be a good option for you in the future.

I'd agree that if you haven't already, seeing a rheumatologist could be helpful. If your GI deals with a lot of IBD patients, she/he might be able to recommend a good one who has experience dealing w/ Crohn's patients.
Posted 6/8/2009 10:36 PM (GMT 0)
Thank you SO much. It is so encouraging and helpful to have these exchanges with fellow Crohnies. Please continue to ring in.

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