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Remicade and Imuran aren't a good combination, increased risk of cancer

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Crohn's Disease
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Posted 8/22/2008 12:14 AM (GMT 0)
I just got home from seeing my GI. I take Imuran 75mg and Remicade. He wants me to taper off of Imuran 25mg a month, then stop. He says he is seeing studies where the use of Remicade and Imuran aren't a good combination because of increased risk of cancer. Has anyone heard of this? I really like my GI and trust him. But, it's always good to get feedback from all of you. Blessings, Julie
Posted 8/22/2008 2:41 AM (GMT 0)
Hi Julie -

My experience with Remicade is limited. I got one infusion and then started Imuran. I am interested to hear what other folks have heard.

How long have you been on the Imuran? I just started this summer and I have no idea how long I am going to be on it. From what I have read, it might be a LONG time before I can stop.

Best of luck -
Posted 8/22/2008 2:42 AM (GMT 0)
Julie1014 This is exactly what my daughters GI told us and he completely took her off of the Imuran in June and she has not had any side effects. Her health stayed the same.
Sylvia
Posted 8/22/2008 2:43 AM (GMT 0)

There are studies that indicate an increased risk of cancer with the two meds in combination.  Keep in mind though, that the risk is still very very small; it's just slightly higher and just enough to be statistically significant.

Perhaps the more important issue is that new studies seem to indicate that once a person is on remicade/humira, they no longer need the imuran/6mp.  In other words, remicade/humira alone is as good as the combination.  So why bother taking both when one is good enough?

I have no personal experience in this, and others who do may chime in.  But from some research I've seen and a conference I attended, what your GI is recommending does seem to be the trend now.

Posted 8/22/2008 3:14 AM (GMT 0)
My son was on Imuran and Remicade and was recently taken off the Imuran and it was exchanged for Methotrexate. The Imuran or Methotrexate is needed along with Remicade in order to alleviate the buildup of antibodies which can happen with Remicade as it is derived from mouse products. Yes, there is some research that indicates that the combination of R and I may cause a higher incidence of Lymphoma alobeit small. My understanding is that it is crucial to be either on Imuran or Methotrexate while on Remicade inorder not to biuld up these antibodies which can make the Remicade ineffective or cause the patient to develope serious side effects.

Posted 8/22/2008 3:19 AM (GMT 0)
After 6 months of Remicade my GI took me off 6mp as she didn't feel it was needed and to try and avoid the increased cancer risk that was mentioned. I believe that recent studies showed a decrease in the build up of Remicade antibodies was reduced with immunosuppressant use only for the first 6 months of concurrent treatment. After that the 6mp / imuran didn't do much to prevent antibodies.
Posted 8/22/2008 2:04 PM (GMT 0)
Bowlies is right. You take the Imuran or methotrexate to help prolong the use of Remicade and its effectiveness. I was on Imuran but could not take it and another med I need at the same time. I was changed to Methotrexate for that reason. There are people with rheumatoid arthritis that take their Remicade with me and they are on Methotrexate also.
Posted 8/22/2008 2:14 PM (GMT 0)
I was not put on the Imuran until the Cade was not lasting the entire 8 weeks. My doc has not mentioned taking me off and I think I would argue about it, only because I know it does make me feel better and seems to prolong the effects of the Cade. I do not want to decrease my length of time between doses right now.
Posted 8/22/2008 2:40 PM (GMT 0)
I heard that for the first time at a conference this spring. The risks were higher on the drug combo (same for 6mp, methotrexate combined with remicade). The expert there said it was best to take just the remicade if possible. Of course, she recognized that some people needed both, but that patient/docs should be cautious before taking the combo.
Posted 8/22/2008 3:16 PM (GMT 0)

A report came out this spring that the Remicade/methotrexate combo is actually slightly less effective than Remicade alone for Crohn's.  (It works for RA.)  So of course my doctor took me off Imuran and put me on methotrexate last week. rolleyes

No problems so far, but no improvement, either.

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