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Metotrexate vs Remicade?

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Crohn's Disease
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Posted 2/24/2011 3:48 PM (GMT 0)

My 17 year old son was diagnosed with CD in Sep. 10' and has been on Entocort and 6MP since. Recently we have been weaning the steroid and have been increasing the dose of 6MP, but he is complaining of pain again.

We are now up to 100mg of 6MP, but he still has subtherapeutic levels, sl. elevated liver enzymes and sl. low WBC. GI has mentioned Methotrexate IM or Remicade.Has anyone had success with methotrexate after failing 6MP, or is it better to go straight to a biologic drug??? Help! Thank You!!!

                                                                                          Livilou

Posted 2/24/2011 8:48 PM (GMT 0)
My concern would be adding methotrexate when the 6mp has already caused elevated liver enzymes.  I have a problem with meds elevating my liver enzymes and had to stop both 6mp and mtx because of it.  Remicade didn't seem to bother my liver.  I was on mtx for arthritis and it helped more than anything else, but had to stop it because of my liver.  If you go that route, make sure they do monthly labs and make sure your son knows that he may have to stop taking it if the enzymes go up.  I knew there was a chance it would happen but I was so upset when I found out I had to stop it because it was the one thing that had helped me.  Now I go into each different med with much lower expectations because I know what's going to end up happening. 
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